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Parasitic infections are fairly uncommon among otherwise healthy people living in most major developed cities. But this hasn’t stopped a wave of social media influencers spruiking at-home “parasitic cleanses” for any number of symptoms such as constipation, fatigue, poor sleep and brain-fog.
“Just comment ‘deworm’ or ‘cleanse’ for more info,” they may say, promising more information about pills with all sorts of “natural” ingredients including wormwood, clove, turmeric, clove, thyme, and black walnut.
But just how common are parasitic infections and what evidence is there that these “cleanses” actually work?
Parasitic infections: common misconceptions
Prof Aaron Jex says he and many of his colleagues who specialise in parasite biology and diagnosis have been contacted by people convinced they have a prolonged, undiagnosed parasitic infection.
They describe symptoms like bowel discomfort, and “a feeling of ‘worms’ crawling beneath the skin or floating in their eyes,” Jex, who leads an infectious disease research laboratory at the Walter and Eliza Hall Institute of Medical Research, says.
“Often, these individuals discuss the hopelessness they feel when seeking a diagnosis, in many cases spending countless hours and significant out-of-pocket expenses to find someone that can confirm that they have a parasitic infection, to be told that no evidence of infection can be found,” he says.
“Many will state that they feel the people think they are imagining the symptoms and that they are ‘all in their head’.”
Jex says he has compassion for people experiencing the symptoms, but often the cause is more likely to be difficult-to-diagnose autoimmune, dietary or inflammatory conditions. This is because, for most healthy people living in major developed cities and suburbs, parasitic infections are uncommon.
“The methods for diagnosing human parasitic infections are also very well known and, in a modern medical system, there is little to suggest the potential that an infection with enough parasites to cause consistent and noticeable symptoms should be undetectable,” Jex says.
What the evidence says about parasitic ‘cleanses’
In 2015, Chinese scientist, Prof Youyou Tu was co-awarded the Nobel prize in Medicine for her groundbreaking work identifying and synthesising the potent antiparasitic drug artemisinin from the wormwood plant. In the same year, Irish scientist Prof William Campbell shared the prize for his discovery of the powerful anti-parasitic drug ivermectin in soil bacteria.
Because these potent and effective compounds are derived from nature, anti-parasitic cleanses containing natural ingredients claim to have similarly powerful effects.
“But both of these compounds need to be purified, concentrated and then synthesised in order to be able to be delivered at an effective, curative dose to a human patient,” Jex says.
“The amount of naturally sourced material needed to represent an effective dose to treat an infection is far beyond what a person could consume.”
Other ingredients in some of the cleanses (garlic, black walnut oil, etc) have some evidence of an effect under experimental conditions in the lab, he says, but they similarly require concentration, further study and validation through clinical trials, he says.
Meanwhile, anti-parasitic drugs prescribed by doctors for gastrointestinal parasites are readily available, well tested, highly effective, and have minimal side-effects, Jex says.
Even ‘natural’ cleanses are potentially harmful
Danielle Shine, an accredited dietitian, nutritionist and PhD candidate researching nutrition misinformation on social media, says so-called natural parasitic cleanses are not necessarily harmless.
“Many contain combinations of herbs, laxatives and other compounds that may cause side effects including diarrhoea, dehydration, electrolyte imbalances, gastrointestinal irritation and medication interactions,” she says.
Severe liver injury and, in rare instances, acute liver failure, have been reported from supplements, she says.
Shine says that so-called “natural detoxifiers” such as zeolites, clays, diatomaceous earth and activated charcoal have no clinical evidence of benefit for parasite cleansing, and may cause side effects or interfere with the absorption of nutrients and medications.
As “proof” that the cleanses work, influencers sometimes include images of their faeces in their posts, claiming parasites can be seen.
“However, parasites can’t be diagnosed by appearance alone, and substances like mucus, undigested food and other normal intestinal material can be easily mistaken for parasites,” Shine says.
Jex adds that normal intestinal material can often “be twisted up into long thread or ribbon-like shapes that can be mistaken for parasites”.
“This is a commonly cited source for so-called ‘rope worms’ which are frequently cited in online forums and social media as the cause of chronic, undiagnosed parasitic infections,” he says.
“However, no such group of parasites have been described in the peer-reviewed, scientific literature.
“Detection and diagnosis of parasitic infections requires an expert properly trained in their identification.”
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