Pregnancy with No Hyperemesis

I am now 7 months pregnant, I conceived right away.  Thankfully I had no hyperemesis.  After one incident of nausea I got acupuncture and felt better immediately.  I have to wonder if my anti-inflammatory protocol helped. I also added oral FemDophilus to my regimen and when I started I inserted one as a vaginal suppository.  I have been faithfully checking my vaginal pH with the over the counter Vagisil test strips.  The lowest it reads it 4.5 and Group B Strep (GBS) cannot grow at a pH below 4.2. Also lactose fermenters prevent growth of GBS. My vaginal pH has not ever gone higher than 4.5, which is great.

Due to placenta placement, I may require a c-section. The Human Food Project posted about a vaginal transplant after a c-section. This can be done by placing a gauze pad in mom’s vagina and removing it and placing it in the baby’s mouth after birth. Or just using fingers to take some vaginal fluid to the baby’s mouth.  This would be a great way to prevent the increased risk of allergic disease due to c-section.

Hopefully I can have a vaginal birth.  The research shows a ~50% reduction in c-sections when a doula attends a birth.  This is probably because during labor a woman is not able to advocate very well due to physiological changes in mental status.  In a hospital setting, the emphasis is on liability for the medical staff, not the best outcome for mother and baby.  A doula is well educated on evidence based birth medicine and will be able to help advocate for the best outcome for mom and baby.  A lot of hospital procedures slow down labor and also create more pain for mom, making interventions such as epidurals and pitocin necessary, both of which can lead to an unnecessary c-section.

I was surprised to learn that delayed cord clamping reduces the risk of necrotizing enterocolitis (NEC). NEC rates are known to be lowered by breastfeeding and probiotics and can be caused by giving formula with too many calories. NEC is a frequently fatal inflammatory condition in premature infants that is associated with lipopolysaccharide crossing the gut and the TLR4 receptor. Obviously breastfeeding and not prematurely clamping the cord are very important to the baby’s health and well-being.  My OB group has never done a delayed cord clamping during a c-section, because no one asked for one.  I have requested this and it is very important to me.  It should be the standard of care because it reduces NEC, intraventricular hemorrhage, and need for transfusions in preemies. An argument I have heard from the OB group is that delayed cord clamping can cause polycythemia. Well, since no one did studies when doctors started immediate (premature) cord clamping, no one knows if it’s really polycythemia or the normal physiological state.  The increased iron from delayed cord clamping can reduce developmental delays in infants, a wonderful reason to delay clamping.

My doula offers placenta encapsulation.  This is when the placenta is steamed and put into capsules for the postpartum mother to swallow.  This helps restore iron stores after childbirth.  My last pregnancy I developed anemia after childbirth and was prescribed iron pills which I had to stop after severe GI symptoms.  It seems like a good idea to consume the placenta after birth because other mammals do this. Placenta is a rich source of stem cells so I would prefer to consume it fresh.  My doula also offers placenta smoothies to make fresh placenta go down easily. I also wonder if it’s a good idea to take placenta capsules frequently because of the iron content, as iron can cause growth of pathological gut flora.

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Birth Defects and Hyperemesis Gravidarum

I have been preparing my body to try to conceive for a year. My fist pregnancy was a disaster, with hyperemesis gravadarium, a birth defect, and polyhydraminos. I’ve been doing a lot of research on how to prevent these problems. It’s been so difficult dealing with my son’s health problems that we waited a long time to have another child. I don’t want myself or a future child to have to suffer these things. Here are some of the things I have done.

I have made sure my body composition and nutritional status are optimized. By using a gram of DHA and EPA a day, getting my vitamin D levels above 70ng/mL, and the paleo diet.  Last time I didn’t eat fish and I didn’t supplement with vitamin D and was careful to avoid the sun.  Sadly I took advice from my doctor, which was the wrong advice. The paleo diet has helped me to have great hemoglobin/hemocrit levels.  I have been dealing with anemia for years and am happy that’s gone.  The paleo diet also gives me the right amounts of fats, and minimizes the pro-inflammatory omega 6 fats and maximizes the omega 3 fats.

Last pregnancy I had borderline gestational diabetes. I wasn’t given the test results because I was in the hospital in premature labor right after the test. So I have worked hard to get my insulin under control.  A low carb paleo diet is just what the doctor ordered.  Along with weight training, high weights and intensity once a week. These both increase  insulin sensitivity.  I’ve checked my blood sugars and they look awesome.

I didn’t know I had narcolepsy last pregnancy.  Which make taking phenergan 3x a day for 5 months while working 50 hours a week total hell.  I ate like crap and could barely keep it together.  Now I eat healthy. I have been gluten free since January 2012 and have been able to ditch the daytime stimulant, only needing Xyrem at night.  So my narcolepsy is under better control. Without the stimulant I don’t get insomnia at night either so it’s a much more normal routine.  However the stimulant may have been a factor in my recently diagnosed adrenal insufficiency, so I’m glad I got rid of it several months ago.

The diet, fish oil and vitamin D have been great for reducing inflammation. I’m also using a low dose of helminthic therapy and probiotics.  Saccharomyces boulardii and Prescript Assist and water kefir. My son also uses them and they have helped his gut issues dissappear.  I no longer have IBS and I love that. It’s important for women to pay attention to their vaginal flora because bad organisms promote inflammation and can cause prematurity and complications.  Candida, HPV, trich, bacterial vaginosis, and group B strep are all bad news in pregnancy. Fortunately I have my own microscope and can look at some of my vaginal flora, and I plan on monitoring for GBS and using vaginal probiotics especially if any bad guys are found. Pap smears and vaginal cultures will also be used for monitoring.

I got my DTaP shot last year and am contemplating a flu shot.  Better safe than sorry.  I will not be getting any vaccines during this pregnancy.

Hyperemesis can be controlled by a low-carb diet according to one fertility doctor. I am torn on this because a low-carb diet can cause gene methylation and cause offspring to become obese. I will experiment with how high I can go while still not taking meds.  My son has similar symptoms as fetal alcohol syndrome and I can’t help but wonder if the phenergan is behind that.  My doctor also offered me Zofran, but to me this seems way worse, as it acts on serotonin in the brain. Not a good thing for a developing fetus.  I plan on using no meds and if I have to going on TPN or feeding tube rather than meds. Some moms who’ve had to use Zofran might think I am over the top here, but after seeing my son hve developmental delays and seizures, nothing is worth risking that. Also I have read that dehydration makes the nausea 10 times worse, and IV rehydration can reverse this, so I’ve already gotten my doctor to agree to saline IV’s if the nausea gets bad.

Avoiding food toxins and other toxins is also a great way to avoid hyperemesis.  The book Pregnancy Sickness explains how high toxin foods such as vegetables cause nausea and vomiting in pregnancy, and gives a nice list of the best and worst foods for the first trimester. Most of these toxins are tetrogenic, including ginger, which most clueless people say to use for morning sickness.  It will be hard to eat a low-carb and low food toxin paleo diet but I will try. Burt meat is another toxin and revolting to pregnant women, so a good solution is boiling meat.  And keeping a charcoal mask handy.

I’ve gotten my doctor to agree to put me on disability, and this will reduce stress, which is tetrogenic.  I absolutely could not do my current job while off my sleep meds.  I would put people at serious risk, and myself too. For most, narcolepsy gets worse during pregnancy.  It’s part of a programmed fatigue designed to keep women from ingesting food toxins.  Thanks evolution!

Finally, I’ve been milk free since March and need to do a blood test to see if my folate antibodies are gone.  Either way the high doses of folate I am taking are covering me.  And the Pregnancy Sickness book says dads should take vitamin C 3 months before conceiving.

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The value of play

Last Child in the Woods is an excellent book about the lost art of outdoor play. Outside play is something we evolved to need, and helps develop motor skills and imagination of children.  Going outside to hide is a great way to a distressed child to calm themselves. Yet many children don’t have access to outdoor play, due to urbanization, or their parents working. When my mom and dad were kids, they used to just go play with the neighbor kids for hours and somehow everyone would just come home all by themselves.  Now parents would be put in jail for letting their kids play without supervision. Not that today’s kids would want to play outside.  The constant exposure to electronics is changing the way our brains are wired but healthy doses of nature can restore some of the lost mental health.  Children such as my son with developmental disorders need daily outside play for the best neurological outcomes.  Fortunately the state we live in allows us to take Jr out of public schooland put him in private school on the state’s dollar.  The private school has an aftercare program where my son gets bully free time with kids his age to play outside for 3 hours each day, 5 days a week.  The boys play softball, the girls play on the swingsets. My son loves it.  Also his vitamin D levels have stayed high even though I stopped supplementing thanks to the sun exposure.  Of course, the exposure to soil microbes is another big reason children need to play outside. Such a simple thing, it’s free to go to your local parks and nature preserves, and anyone can have a container garden even if you live in an apartment.  It has done more good for my son than expensive occupational therapy.

Camping is another low cost way to connect with nature and something my son gets really excited about.  I am blessed to have parents who made camping a priority and have really fond memories of that. It’s beautiful to see my son’s love of nature develop.  Teaching him bird calls has helped his auditory processing. Nature is a multisensory treat!

Many years ago I read a book called The Healing Woods about a woman with some incurable disease.  Someone told her to go live in the woods and she found a guide and did go live in the woods and she got better. I must find it and read it again. Anytime I am in a bad mood, a forest can cheer me right up.

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Biopsy Results, Anti-Folate Antibodies

My son had a biopsy of his esophagus Monday.  The result is the EE is no better or worse. This leads me to consider the possibilities:

1. Worms do not help EE.

– Really don’t know. My son has always been asymptomatic so I can’t ask him how he feels.

2. Worms take longer to help EE.

– Most people using helminthic therapy start to see some results after 3-6 months. It’s been 7 months since the helminths reached the effective stage.

3. Need a higher dose of worms.

– This is my main thought, based on the doses adults need to go into remission from IBD.

4. Could just prevent more damage while not reversing the existing damage.

– Perhaps, since he doesn’t seem to be worse.

The goal now is to add more helminths. They are not hurting him at all.  Also, he started a course of IVIG for his hypogammaglobulinemia.  Hopefully that will improve the seizures and EE.  Some people on the yahoo EGID group said IVIG helped their kids.

There is a new autoimmune disease rocking the autism community.  It’s caused by folate antibodies that block the passage of folate across the blood brain barrier. This can cause “neurodevelopmental symptoms including spastic paraplegia, cerebellar ataxia, dyskinesia, seizures, acquired microcephaly and developmental regression”.

My son and I both tested positive for two out of the two types of antibodies present in this disorder. Mine were relatively low while my son’s were high.  This could explain the treatment resistant epilepsy and is treatable with B vitamins.  I would trade B vitamins for toxic anti-epileptic drugs (AEDs) any day.  AEDs already failed him. And IVIG could help with this too. A milk free diet helps lower the antibodies, because it seems milk is the trigger for the folate antibodies.  This is because mammal milk contains folate receptors.

A real scientific explanation why the GF/CF diet helps autistics!!  He’s never been milk free for his EE biopsies, and I read somewhere that milk was one of the major triggers of EE, even when the allergy testing is negative. Hate to loose another food, but milk is making him sick.  Basically we are both on a GF paleo diet, and I am CF too because of the antibodies. It’s doable. is my go-to website for easy wholsome recipes.  Go food!

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Hypothesis on how to treat Eosinophilic Gastrointestinal Disease

This is my hypothesis on how to treat and prevent EGID, based on stuff I have read in the biomedical literature.

1. Create an anti-inflammatory environment.

  • Adding helminths back to the intestines. We evolved wtih them over thousands of years and it’s only in the last century they have been removed. They activate Treg cells, calm dendritic cells, and stimulate alternatively activated macrophages.
  • Adding in probiotics. Perhaps even fecal transplant if good donor could be found. Also including consuming organic soil. Plenty of research showing difference in gut flora of those fed formula vs. breastfed, and the differences in allergy between the two populations. Also research showing antibiotics weaken the immune system via the inflammasome. And exposure to dirt prevents allergy, while clean living leads to allergy.
  • Adequate Vitamin D levels.  Vitman D affects every cell in our bodies and plenty in the literature to show it has a profound effect on the immune system.  Along with excessive hygiene, we are spending too much time inside.
  • Eliminating allergic triggers.  This would include going on an allergy elimination diet (if you were able to identify the triggers), elemental formula, allergen coverings on mattresses/pillows.  Any way it would be possible to get to  a baseline of lowering inflammation
  • Omega 6: omega 3 balance.  Finding a more evolutionary friendly balance of omega 6 to omega 3 fats, along with getting sufficient fats in the diet.
  • Eliminating carbs.  Especially high fructose corn syrup, which is inflammatory.  If possible either a paleo, SCD or GAPS diet.
  • Adequate sleep.  Sleep deprivation is pro-inflammatory. Excess light at night blocks melatonin production, so turning out the lights or wearing blue-blocking glasses would be one way to help this.  A melatonin supplement might be tried.
  • Stress reduction.  Stress will add to the inflammatory burden.  Stress has been shown to affect white blood cells, for example natural killer cells.  The best thing is to avoid stressful situations.  For the youngsters, this might mean homeschooling.  For adults, it might mean going on disability.  Adding in fun is also important.  Healing touch.  These things are underestimated in medicine.

2. Immunotherapy for allergic sensitization.

  • Sublingual immunotherapy (SLIT) is the most gentle and safe form of allergen immunotherapy that has proven efficacy.  Good for seasonal allergies.  For foods, can bring people to a level where they can tolerate exposures to foods while sometimes falling short of functional tolerance.
  • Oral immunotherapy (OIT) would probably best be started after reaching a maintance dose with SLIT. This can get many of the people in the studies to a dose where they can consume the problem food.
  • I do not think subcutaneous immunotherapy (SCIT or allergy shots) is safe or effective enough for people with EGID.

So I would first address the inflammation, and then the allergies.  In experimental animal models, oral exposure to allergen in the absence of inflammation or an adjuvant leads to tolerance.

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Citizen Science

We started helminths, necator americanus (NA), back in July 2011. The little one did awesome on a low dose (10 NA), one day of stomachache. I took 25 NA and was not so fortunate. It seems the people with fibromyalgia/ POTS/ CFD/ narcolepsy do poorly with doses of helminths most people can handle. I had 2 weeks of diarrhea and at the same time my POTS got really bad. My stool showed massive amounts of charcot-leyden crystals. So I took antibiotics and started over at a very low dose in October. That went well and I added a few more NA, bringing my total to 11 NA.

I also took 500 trichuris trichiura (TT) in June of 2011 with no problems. The antibiotics I took for the NA should have killed the TT, but a few TT hung in there (I confirmed with stool checks).

My helminth use is under the medical supervision of my allergist. Jr’s helminth use is under the supervision of his allergist, GI, and pediatrician.  I haven’t seen any benefits yet, but the little one seems to be having great results. A huge increase in fine motor skills. His stools are firm and regular even though I got lazy with the magnesium and flax. He is now potty trained for #2, which is a miracle, after all those surgeries and years of diarrhea.

We are also using Prescript Assist and Saccharomyces boulardii about every 3 days. All systems are go. No more seasonal allergies, and viruses come and go with few symptoms (compared to ending in secondary bacterial infections). He’s flying through his food exposures with no problems.

Now he has finished the slowly increasing nut/sesame exposure. He had been eating 1/4 teaspoon of mixed nuts/sesame every day for several weeks. Seems to tolerate very well. I am still not sure if the nuts and sesame were false positives, as he had eaten them before with no IgE symptoms. But this is EoE we are dealing with, with no reliable way to test which substances are triggering the process. Hopefully with the helminths downregulating the eosinophilic response, and the probiotics and helminths creating an anti-inflammatory milleau in the dendritic cells in the GI tract, the foods will no longer trigger an eosinophilic response. I am using a Larabar cut up into 10ths as maintenance dose for peanuts (peanut butter cookie) and treenuts (apple pie), and a sesame bar for sesame maintenance.

It’s delightful to think that he will be able to get rid of the allergies. The next step is continuing chicken/turkey/lamb and fish/seafood exposure. When he gets to the max dose of those, I think I will make some kind of meatball or nugget for him to eat every day. I plan on keeping him eating these things for 3 years to permanently change the immune system. After he is able to tolerate fish, he will have skin testing redone. If skin testing is negative, we will rescope.

The allergist is excited. Little one’s blood eos had been high, holding at 10-15% with no parasites on board. After the first dose of NA, they shot up to 19%. Last week they are back down to 10%. Let’s just say for example most people with helminths have eos at around 10%, and my son averages around 10%, so you would expect my son’s blood eos to be around 20%. But the NA release chemicals that stop the eosinophils from migrating into tissue, along with other chemicals that downregulate the anti-parasite response. It seems the chemicals are being released and stopping the eosinophils. It’s just amazing to me how much this is affecting his brain for the better. Hopefully the gut is responding the same way.

I am in touch with a few other families that are using NA with EoE and EGID kids. Most need benadryl or prednisone to get through the “worm flu” stage where the body is attacking the helminths, before the helminths reach the stage where they release anti-inflammatory chemicals. This stage is around week 5-6 after infection, when I had a hard time. After this stage helminths are well tolerated, causing no symptoms. The only other problem would be too many helminths, this would cause anemia. So this is why my son and I get regular blood tests. No signs of anemia. In fact, I had been dealing with anemia on and off for a few years, but then I started on the paleo diet and have not had any more anemia. You could say we are taking primal living /natural parenting all the way, even replacing our lost helminths. The little one is very loved, and his health is well cared for. He has never been as healthy as he is now with a few of his lost friends back in business.

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Clueless Clinicians, More Research Needed

This story made me very sad. The food trials kids are put through are ridiculous. All they do is teach the kids food is bad. These doctors are not reading the research on how to change the way APC’s process antigens with microbes. This kind of thing is labeled as “alternative”. Could I be the only person in the world trying to heal my child’s EE with microbes after spending thousands of hours on Pubmed to figure out the causes and reversibility of loss of oral tolerance? If the child lost oral tolerance, who says time will fix it? No science to support these types of abrupt high dose food trials. They may identify foods a patient is not yet sensitized to. But they won’t reverse EoE. It’s also bad for children’s brains to repeatedly by put under for procedures. Seems like docs knew the kid had EoE so why torture him with NG tubes? This will only create oral aversions that costs time and money to fix later. Grrrrrr. Hugs to the family.

We really need a non-invasive marker for EoE status. Dr. Rothenberg has already taken out patents so that is looking good.

I think food trials are completely ridiculous. Could extremely slow immunotherapy be done with these patients? With microbial therapy at the same time to promote tolerance of the antigen? How about adding a mucosal adjuvant like CpG DNA or LPS? I wish I could go back to school and do this research. This COULD be done with animal models of EoE!

My suggestion for a clinical trial:
Create EoE mice by intraperitoneal injection with ovalbumin and nasal challenge.
Try ovalbumin oral immunotherapy with 4 groups of mice: non-infected, Trichuris muris infected,
Nippostrongylus brasiliensis infected, and Heligmosomoides polygyrus infected mice. See if it improves the EoE.

Another experiment: Infect the mice with the above 3 helminths and do the procedure to induce EoE. See if the infected mice do not develop EE or develop a milder form.

Another experiment: do like Dr. William Parker and use wild rats and lab rats. Try to induce EE. Also during the experiment compare microbes between wild and lab rats.

I think the folks at CCED could do these experiments. Perhaps the idea has not occurred to them. The reality is that EGID patients are experimenting with helminthic therapy already. With their doctor’s approval (and a rx for anti-helminthic drugs just in case). Only the geekiest of families are going to their docs and saying “lets try this, because nothing else has worked, and it has a very low likelihood of causing harm, compared to other EE treatments”.

Hoping for a better future for those of us suffering from EGID.

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Dirt on the menu

I have had dirt research on my list of things to do. I know it prevents allergy, but can it treat allergy?

According to Anil Patki, dirt is “microbes found in feces and feces-contaminated soil”. Joel Kline shows in his article that dirt is an effective adjuvant to immunotherapy, especially in eosinophilic type inflammation. His group did an experiment where they took bacterial type DNA (CpG) and make mice allergic to OVA (egg protein), which also gave the mice airway eosinophila.

They did 4 weeks of injection immunotherapy with saline, OVA alone, OVA plus CpG, and CpG alone. Then they challenged the mice with inhaled egg protein. The mice not given immunotherapy (saline control) developed lung eosinophila after the challenge. The mice who got OVA + CpG had the best results, greatly reduced lung eosinophils.

Kline also said that this bacterial DNA supressed eotaxin and increased T regulatory cells. Eotaxin is involved in EGID and is also suppressed by Necator Americanus. They have shown that oral immunotherapy also works, but you must use more bacterial DNA.

This gives me hope that people with EGID already sensitized to allergens can become desensitized. The first step would be to increase the exposure to bacteria via probiotics and dirt. The second step would be helminthic replacement therapy. The third would be oral immunotherapy/sublingual immunotherapy. Klein’s research shows that eosinophilic inflammation will not go away by itself, and that immunotherapy against the offending allergen can stop the eosinophilic response.

We are already using probiotics, so I am hoping to find an organic farm to gather some fresh healthy dirt from. I plan for us to actually eat some dirt, and also am going to put it inside jr’s stuffed animals for more exposure. Goodbye excessive hygiene, hello dirt! Yum!

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Maintenance dose

My son made it to maintenance dose with his allergy drops.  He either just came down with a cold or is getting his first allergy symptoms, sneezing, post-nasal drip, and my friends are all suffering from allergies, tis the season. It’s only been a few days so my money is on a cold.  Other than that he has had no symptoms at all.  The allergy nurse said some people are not yet in remission when they reach the maintenance dose.  Probably why they put the patients on maintenance drops for 3-5 years.  You can’t change the immune system quickly.  Slow and steady to retrain it.  It will be a nice change going from different numbers of vial/drops to one vial/one drop every day.

I just started my course, figuring since we both will be on maintenance for 3-5 years, we might as well do it together. I have 4 vials (my son only had one) because I am allergic to everything airborne.  I can’t wait for the sinus headaches to go away.  But most of all I am doing this for the child I would like to carry next year.  Undergoing immunotherapy during pregnancy causes changes to the immune system that can result in less risk of allergy in the unborn child.  Sure, it sounds crazy to be worried about allergy in my next kid but I don’t want this child to end up with EGID or even mild allergies.  I guess this is going to be quite an experiment, we’ll see if it works.

I was kinda surprised at the taste.  Slightly salty, slightly menthol or alcohol?  And it’s difficult to hold them under the tongue.   What do you do when the saliva starts pooling, are the drops still under the tongue?  The doctor said I could also put them in the space around the teeth.  La Crosse allergy, another place I researched, uses glycerin so the drops can stay put.  From my research, anywhere in the oral mucosa is great and they should be swallowed. Whether they get into my oral lymph nodes or the lymph patches in my intestines, the allergens should still induce tolerance.

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The Immune Disease Epidemic and the Hygiene Hypothesis

Once upon a time, there were no doctors.  Women had as many kids as they could because many of the kids would die.  The women often died too.  All children were born vaginally and breastfed.  No one had toilets, feces got into the water supply and caused illness and death.  Children were exposed to parasites through feces they would step in.  Eventually new knowledge and technology such as the invention of the microscope changed that.  Sanitation and toilets became standard.  Pasteur did experiments that proved germs existed, and he discovered ways to protect people.  People started living longer, vaccines and antibiotics were invented, C-sections became a valid option.  Handwashing was discovered to save women who were giving birth in hospitals.  Soon, children started receiving vaccinations and child mortality dropped.  The polio vaccine saved many children from paralysis.  Antibiotics became routine for childhood and prenatal infections.  Our microbiome was drastically affected by these changes.

Babies are born sterile and get their gut flora from mom’s vagina.  Then gut flora is selectively built up by prebiotics and antibacterial substances in breastmilk.  When a woman’s vaginal flora is disrupted, it makes her more vulnerable to STD’s that can hurt her or her baby.  If she is given antibiotics to kill the bad organisms, the normal flora may not be re-established.  Some women are given antibiotics for things such as group B strep right before delivery.  Or the mom might need a C-section.  Many babies miss their first taste (literally) of good healthy microbes from mom’s vagina.  If the baby is not breastfed, it misses out on that chance to develop a normal gut flora.  Breastfed and formula fed babies have 2 different types of flora.

We have clean water and toilets.  Dirt is viewed as a horrific thing.  Many children grown up in urban areas with little greenspace.  The little greenspace left is sprayed with herb/pest-icides, and marked with a sign stating “keep off the grass”.  This has bad results not only for our immune systems but also for learning.  Children need to play outside.

Probiotics are known to help immunity, they can reduce the rate of developing allergies and the chances of getting a cold.  This is now a big business, and we haven’t even reached the tip of the iceberg.  The human microbiome project is categorizing all the organisms that live in the human body.  When/if they categorize the ones that live in our intestines, we will have much better quality probiotics than the ones we have now.

It’s not just bacteria that are important to our immune system.  We used to have lots of exposure to parasites.  Fighting parasites was a high priority to our immune system.  And the parasites evolved along with us.  The ones that are adapted to living inside humans have various strategies for evading our immune system.  Soil transmitted helminths (worms) live in the intestines.  The body’s defense against parasites is allergy and inflammation, so these worms release chemicals that selectively turn off parts of our immune system.  If they turned off the whole thing, we would die, and so would the worms.

Helminths are being studied as a “new therapy” for immune conditions such as autoimmune disease and allergy.  The more I read about them, the more I think that this is a beautiful idea.  Two types in particular are very attractive probiotics.  Human hookworms, a type called Necator americanus; and whipworms, called Trichuris Trichiura (human version) and Trichuris Suis (pig version [TSO for short]).  They cause few symptoms when controlled doses are given, and they stay active in the body for a long time, up to several years for human whipworm and hookworm.  It’s like taking a steroid without the side effects.  Maybe children should be given these in controlled doses to mimic the natural exposure they would get if we didn’t have sanitation.  Especially in families at high risk of allergy and autoimmune disease.  An ounce of prevention.

These soil transmitted helminths are still common in the third world.  According to the CDC, 500-700 million people are infected with each (hookworm and whipworm).  The major problems they cause are anemia leading to developmental delays if the infected children are malnourished.  Diarrhea is another symptoms of heavy infection.  Children who are given medication to kill their worms often develop allergies.  Even pregnant women who are de-wormed during pregnancy have a higher chance of having allergic kids.  I think that helminth deficiency is probably behind the huge increase in allergy, autoimmune disease, and autism.  In fact, TSO has helped an autistic young man, and sparked a clinical trial.

Scientists started to notice that allergies and autoimmune disease are basically non-existant in countries where people still have worms.  Researchers began experimenting with replacing the worms in people with inflammatory bowel disease.  The worms cured many of the people and were safer and had fewer side effects than the drugs people were taking.  Helminths have been shown to help Crohn’s disease, ulcerative colitis, allergies, asthma, and MS.  There are active clinical trials using helminth therapy for celiac disease, peanut allergy, autism, and MS.

I hypothesize that helminth replacement would help in eosinophilic esophagitis and EGID’s.  For one thing, the eosinophilic response is designed to fight off parasites, whether in the skin, lungs, or GI tract.  There are corresponding allergic diseases where you see eosinophils in the skin (eczema), lungs (asthma), and GI tract (EGID’s).  Hookworms release chemicals that block eosinophils from getting into tissue.  Whipworms also release chemicals that reduce intestinal and brain inflammation.  Both of these worms cause the creation of Treg cells.  Because hookworms can block eosinophils from getting into tissue, they have the potential to cure EGID’s.  In fact, the reason that rates of EGID’s are increasing could be due to altered gut bacteria and helminth deficiency.  Another interesting point is that people get eosinophilic gastroenteritis when infected with certain non-human parasites, but not when infected certain human parasites, showing that the human parasites can inhibit EGID’s.

If excessive hygiene is the cause of the epidemic of immune disease in civilized countries, what then is the solution?  For a start, reducing antibiotic use.  They should be a tightly controlled substance, reserved for only the most extreme cases.  The super-bug epidemic plus the immune epidemic is plenty to say that we need to stop giving out antibiotics like candy.  We should continue to study the types of gut bacteria and type them so we can make better probiotics that resemble real gut bacteria, not just a few strains like in yogurt.  Limit vaccines to the most dangerous bugs, not offer new vaccines out of the convenience of not getting sick (cough chickenpox), and make existing vaccines safer by eliminating additives not related to the vaccines.  We should eat real food, and ban pesticides, hormones, antibiotics, and xenobiotics in our food and water supply.  We should find a way for children to be exposed to low doses of intestinal parasites, without giving up the benefits of toilets and sanitation.  We should ban antibacterial chemicals in household products and hospitals and just use 10% bleach or diluted vinegar for our cleaning needs.  We should ban germfearmongering advertisements from cleaning companies (cough Lysol).  Mothers should be given a paid year off after the birth of each child so they can breastfeed them for a full year.  Baby formula companies should not be allowed to advertise, and formula should also be restricted to prescription only.  Human milk banks should be started.  There should be free childcare and sick childcare available so mothers would not be tempted to get antibiotics for their kids to prevent being penalized for their sick kids.  Drug companies should not be allowed to advertise, period.  The US healthcare system should be revamped to promote wellness instead of procedures and medications.  I know these ideas are radical, but if the capitalists only knew how much money these rules would save us, they would be all over them.  Health and wealth for all.

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