A lot of health advancements made in the 20th century were the removal of various viruses, infections, and pathogens that visibly caused disease.

What seemed so triumphant about these eradications is they seemingly stamped out illness with no apparent side effect.  We put on our helmets, rolled up our sleeves, and got to work vacuuming up every environmental pathogen we could find.   No stopping until everything’s squeaky clean.

A lot of these initiatives worked really well.  Polio, malaria, small pox, tetanus, and typhoid fever are some of the diseases we’ve wiped off the map in the 20th century, and many people are living longer as a result.  The eradication of disease has also led to cultural norms that promote the removal of all pathogens without prejudice.  Hand washing, sanitizers, household cleaners, daily showers, fluorinated water, mouthwash, deodorant, vaccinations, and pasteurized food mean from cradle to grave we’re usually insulated from exposure to pathogens of all sorts.

Most of this is beneficial, but it hasn’t come without a cost.

Around the same time we started getting rid of diseases from parasites and pathogens a new illness began to spring up like a weed:  the autoimmune disorder.  Simply put, an autoimmune disorder is when your immune system recognizes something as foreign and begins to attack itself, even if it’s to your body’s detriment.

They come in two flavors.  The first is an allergy, which is when your body’s immune system doesn’t recognize a digested protein and unleashes hell to make it go away.  Allergies to soy, peanuts, wheat, gluten, yeast, dairy, and practically any other large category of foodstuff has increased 200-300% the last fifty years.

The second type of autoimmune disorder is when your body actually begins to attack its own tissues.  Crohn’s, Coeliac, Type 1 diabetes, and IBS are common examples of debilitating conditions caused by an immune system gone mad.  These diseases have had even faster growth rates, topping up with a 300-400% increase since the middle of the century.

So is the disappearance of parasitic diseases causing the emergence of autoimmune disorders?

Sadly, the answer might be yes.

Parasites: Our Misunderstood Enemy

Russ Roberts just did a fascinating podcast with Moises Velasquez-Manoff, who just wrote the book An Epidemic of Absence.  It’s about how pathogens, parasites, and bacteria co-evolved with practically all living creatures and serve a useful role in warding off disease, even if they cause a few of their own.

It’s an under-appreciated fact that there are 10x more bacteria in your body than there are living cells, as Moises points out in the interview.  Consistent exposure to a wide variety of parasites of all sorts at the right time might be the key to developing an immune system that knows when to bite and when to retreat into silence.

During the podcast the point is made that populations with a low prevalence of autoimmune disorders share one thing in common:  they’re exposed to a diverse set of pathogens early in life.  Kids that grow up in big families, kids that grow up on farms, and kids that suffer through bacteriologic infections all seem to be insulated from the vagaries of an over anxious immune system.

I’m reminded of the humorous quote by Kelly MacLean in her article on Surviving Whole Foods:

 Ever notice that you don’t meet poor people with special diet needs? A gluten intolerant house cleaner? A cab driver with Candida? Candida is what I call a rich, white person problem. You know you’ve really made it in this world when you get Candida.

Turns out she was right.  Wealthy urbanite germophobes really are sanitizing their kids into gluten intolerance!

Your Immune System: Part Student, Part Nihilist

Vaccinations are the standard example used to illustrate how our immune system works.  We inject our bodies with some sort of illness, our body develops antibodies to defend against it, and the next time the pathogen enters we’ve got a small army waiting for it.

This process happens as described, but our immune system might have another side to it that’s a little less patient and a little more vigilant.

In the absence of stressors and parasites our immune system begins to act like a bratty child with a violent streak.  It narcissictically starts launching grenades at whatever comes its way, and without a hookworm or malaria virus to keep it busy then harmless foods and even our own tissues become items of attack.

This basic hypothesis has been tested on animals and so far the results are fairly consistent:  when you remove the typical gamut of immune system stressors they begin to develop autoimmune disorders the same way humans do.

The….(Ahem) Cure for Autoimmune Disease

If you combine these observations about parasites and autoimmune disease there’s a common sense idea for how to treat them:  maybe we need to re-infect ourselves.

Not so much to be harmful, but perhaps there’s a “sweet spot” for infestation that a lot of us are missing right now. In the book Moises talks about a lot of people who are doing just that.  Except you can’t really do it in the United States because it’s illegal to sell organisms that are known to cause illness.

So instead they had to turn to a trusted, tried-and-true supplier of digestible items we want but can’t have: mexican narcotics dealers.

Okay, not quite…..but close.

Dosing yourself with parasitic worms has become a popular treatment for people with autoimmune disorders and an adventurous DIY attitude, and one of the most common ways to re-worm yourself is to go to a pharmacia south of the border.

It does seem to work, but you should not run out and get yourself a plane ticket to Mexico City because there are just as many horror stories as there are miracles.

But think, this would seem to suggest a new paradigm for how we think about dirt, filth, the environment, and how we ought to interact with it………right?

Further Reading:

A scholarly paper on the incidence rates of autoimmune disorders in the developing world.

Wikipedia article on the hygiene hypothesis – the idea that exposure to germs prevents autoimmune disorders

A useful message board discussion about using worm therapy to treat Crohn’s…and some discussion of going to Mexico to do it

How to purchase helminthic (worm) therapy (warning: I have NOT tried this and can’t vet for it.  Caveat Emptor!)