Hookworms in the medical news

Why are there two stories about using hookworms as medical treatments? No idea — let’s just call it a happy coincidence.

For inflammatory bowel disease

There are people with ulcerative colitis who self-medicate with, as you might have guessed, hookworms. They swear by them, but we all know that “the plural of anecdote is not data.” So Kiwi researchers went out and got that data.

It turns out hookworms do in fact work to manage symptoms — and they do it better than medication for one simple reason: They’re “infect and forget.” A single treatment is all they needed rather than daily or twice-daily doses of medication.

“One of the key findings from this study was that a single dose of hookworm can reside in the body for several years, if not longer. […] The worms just sit there in the background and do their thing.”

This research didn’t look into exactly how it works, but one idea is that the hookworms help ‘distract’ the immune system and keep it from overreacting.

Which leads us to the second hookworm story:

For multiple sclerosis

If hookworms can help keep the immune system in check, it makes sense that they might help a disease like multiple sclerosis. Thus some British researchers did a nine-month study of 71 patients to see how the worms might affect the brain lesions that are a hallmark of MS.

They found two effects. First, more than half the patients receiving the hookworm treatment (25 of the little buggers) showed no new brain lesions. And that might be related to the second effect: an increase in the number of regulatory T-cells, which keep the immune system from attacking the body.

[T]he presence of hookworms in the body switches off the mechanism by which the body’s immune system becomes overactive — the main cause of MS — reducing both the severity of symptoms and the number of relapses experienced by the patients.

The effects, they admit, are minor; existing MS treatments are much stronger. However, “some patients with milder disease or more inclined for natural treatments may consider this as an option.” And, of course, more research is needed.

A statin alternative does more

Using bempedoic acid as an alternative to statins isn’t new — the FDA approved it three years ago because it can lower LDL cholesterol without the muscle-pain side effects. But it turns out that bempedoic acid also has another effect: It can reduce cardiovascular events overall, especially heart attacks.

That’s the conclusion from Cleveland Clinic researchers, who studied BA’s effect on 14,000 people who were statin-intolerant.

People who took daily doses of bempedoic acid for more than three years had about a 23% lower risk of having a heart attack, in that period, compared to those taking a placebo.

That makes bempedoic acid not just a good alternative to statins, but — thanks to the lack of muscle issues — a really good alternative.

Caveat? Yep. The study was partially funded by Esperion Therapeutics, maker of the brand-name version, Nexletol. It costs $400 per month (sans insurance) compared to about $3 for something like simvastatin.

A post-stroke nose drop

Mice who’ve had a stroke have some good news: a nasal drop that can help them recover faster and more thoroughly. Swedish researchers have tested a new treatment — a molecule called C3a — that helps nerve cells recover by increasing connections among the mouse brains’ nerve cells. The mice “recover[ed] motor function faster and better after stroke compared with mice that had received nasal drops with placebo.”

The best part: It can be given even a week after the stroke. (In fact, it can’t be given too soon because it might cause dangerous inflammation.)

In a conceivable future, most stroke patients could thus be included — even those who do not reach hospital in time or who, for other reasons, are not helped by clot-dissolving drugs (thrombolysis) or mechanical clot removal (thrombectomy).

Questionable testing

…for vitamin D?

This comes out of Australia, but it might very well apply to kids here in the US. A study out of the Australian Institute of Health Innovation found that vitamin D testing in kids has skyrocketed.

We all know that having enough vitamin D is important for a host of reasons — study after study shows that it can reduce susceptibility to diseases, protect the heart and brain, and of course prevent rickets. But, the Aussies found, it’s better to simply supplement kids’ diets longer rather than subject them to unnecessary tests (unless there’s a good reason to think there’s a problem).

“GPs need more education about the latest evidence-based global guidelines, so that prevention rather than testing is their first choice, and patients get best-practice care,”

…for hormone levels?

Sure, you’re probably happy to help a patient treat a hormone deficiency, but we also bet you’d probably like to avoid giving someone unnecessary medication.

The thing is, found the Atlantic, there are a lot of people who jump to the conclusion that their hormones are out of whack. Why? One guess. It’s thanks to advice they get on (wait for it …) social media. So they turn to home test kits they buy online.

Problem: Those home tests are unreliable — the technology isn’t there yet. That doesn’t mean they’re wrong, just that they can’t be completely trusted. At best they can start a conversation with a legit healthcare professional. At worst, they can delay treatment for a real issue, or suggest (and sell) unnecessary medication.

Short Take

Semaglutide: So many body parts, so little time

“Wegovy Butt” and “Ozempic finger” have joined the list of side effects (e.g., “Ozempic face”) from semaglutide. Yay!