Gut Bacteria

#132: Moises Velasquez-Manoff – An Epidemic of Absence: How Parasites Affect Autoimmunity & Allergies

by Mike Mutzel


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About Moises Velasquez-Manoff

Moises Velasquez-Manoff is a journalist and author based in California. ‘An Epidemic of Absence' is his first book. He has written extensively, mostly on science and environment, for The Christian Science Monitor. His work has also appeared in The New York Times Magazine, Chicago Tribune, and the Indianapolis Star, among other publications. He holds a master of arts, with a concentration in science writing, from the Columbia Graduate School of Journalism.

Books Discussed in This Podcast

An Epidemic of Absence: A New Way of Understanding Allergies and Autoimmune Diseases

Connect with Moises Velasquez-Manoff

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Show Notes

02:16 The Role of Parasitic Worms (Helminths):  A subfield of archeology studies fossilized feces, called coprolites.  In fossilized human feces, parasites appear in every time period. All animals have parasites. There are more parasitic species in existence than non-parasitic species.  Parasites convince our immune system that they belong, and take up residence for years, even decades. In a way, they take control of your immune system. We evolved with this constant pressure on our immune system to tolerate things. We have become dependent upon these parasites for physiological functioning.  For example, vitamin C is necessary for certain cellular processes and most other animals generate their own. Primates have lost that ability. Our gene that controls the production of vitamin C stopped working because we were getting enough in our diet. We have outsourced our vitamin C production to plants and are not dependent upon them. The theory is that we have outsourced part of our immune system control to helminths.

06:20 T-Reg Cells as a Mechanism: Every cell subset has a regulatory version, front lines of your immune system that grab and invader and educate the rest of the immune system. T-cells attack and T-reg cells are like the officers in the army and decide when and who to attack. About 10 to 15 percent of our T cells are regulator T-cells. Research shows that when T-reg cells are removed, the attack cells don’t just cause autoimmune disease, but over-react to any immunological stimuli.

08:27 Helminths and Hormone Regulation: Systems in our body are not separate. Your endocrine system is not separate from you immune system. Chronic infection is costly to the body’s energy stores to keep the immune system at strength. There is less energy to invest in other areas like procreation. In animal studies, as soon as a rat is infected with helminths, sex hormone levels drop. It may not be reflected in a reduction of fertility. It seems that they make better use of the hormones they have. Our healthy, well fed western populations have hormone exuberance. This is unprecedented in human evolution. Rates of current reproductive cancers in the west have risen. Some of the rise is due to better diagnosing, but much can be attributed to hormonal exuberance.

12:31 How Did Humans Get So Clean? Social living breads pestilence. For much of our evolution, we lived in small groups. Parasites love small groups. Crowd diseases like small pox and measles are big killers. These do better in large populations because the virus needs to find a new host before it is evicted from our bodies.  Crowd diseases came with agriculture and settled living. The past 15,000 years of human history has been a gradual buildup of pestilence and filth, which culminates in the industrial revolution with huge migration into cities with little to no sanitation. In the 19th century we began the sanitary revolution with sewers, clean water, and a basic understanding of germ theory. Suddenly this genome that had been exposed to ever increasing quantities of filth, parasite load and crowd diseases, is left with none of this. With a lack of parasites, we no longer had the tolerance influence to suppress immune reaction. The things that seem to be protective, in terms of autoimmune disease and allergies are not the things that we vaccinate against. There is no benefit to avoiding vaccination to avoid allergies and autoimmune disease.

16:46 What Can We Do? Moises does not advise recklessly exposing yourself to parasites.  Companies are trying to develop a next generation called “Rationally Designed Probiotics”. Present day probiotics are often derived from fermented foods and are not FDA approved for anything. They are microbes that have been determined or hoped to be good for us. The next generation of microbes will be from the human microbiome and will be scientifically tested to determine which communities of microbes are key to immunoregulatory circuits. We should eat a lot of soluble fiber (vegetables, fruits, and nuts). Regular exposure to livestock or even owning a dog has been shown to be protective. Dogs diversify the microbiome of your home and bring in outside microbes, reducing allergies in kids. You need chronic stimulation, not occasional, for it to be effective. Getting outside and in the dirt may help.

22:22 Parasites vs Symbiont: The simple definition of a parasite is something that is taking something from you and not contributing to the whole.  But the theory of parasites being constantly in our past and being a necessary component of a healthy human immune system complicates this idea. Is it a parasite or a symbiont?

23:20 Self Treatment Caution:  Be skeptical. Parasites or symbionts, they are not entirely benign.

23:43 Helminths: Scientific evidence of disease treatment efficacy is poor at this point. The pig whip worm, helminth or trichuris suis, has been rigorously studied and seems almost miraculous.  Coronado Biosciences has done larger studies, trying to bring them to market. It was a total failure.  Perhaps the study was not well conducted or maybe they just don’t work. The theory is that if you grow up with parasites, autoimmunity, allergies and the like, are less likely to develop. Introducing parasites once a disease is in progress and the immune system is off balance, affects the ability of the parasite to control the immune system. We can find stories of miraculous recoveries from helminths on the internet and many may be true, but we do not find the stories of where it did not work or where it made people worse. The scientific method is a pain to do, but in the end, you are far more likely to be able to trust the results.

26:32 Hookworm Study: A small study of hookworms theorized that the pig whip worm was never meant to reside in the human body and would not work. The necator americanus hookworms are human adapted. In the non-blinded and non-placebo controlled study, they infected a small number of people with celiac disease. They leveraged the tolerogenic influence of the parasite to desensitize study participants to gluten, byfeeding subjects ever increasing amounts of gluten over the course of a year. By the end of the study, people were able to eat the equivalent of a bowl of pasta with no reaction.

28:03 Parasites and the Gut Microbiome: The hookworm study also looked at changes in the gut microbiome. With the introduction of the hookworms, diversity of the microbiome increased. Generally people with celiac have an impoverished microbiome.  When ecosystems are more diverse are generally healthier, more productive, less prone to disturbance or invasion.  In rodent studies, helminth infection seems to increase diversity and increase metabolites (fermentation byproducts) of the microbiome that are thought to be healthy.

30:32 Growing up with Parasites: Evidence indicates that the greatest impact is during the first few years of life. Suppressing the immune system early on may keep us off the road to disease. The part of your immune system that gives you allergic disease is also the part of the immune system that evolved to deal with helminths. The theory is that if the immune system is busy with helminths, you won’t have allergies. Studies of people of the Amazon with parasites have allergic antibody levels can be hundreds of times higher than someone who has hay fever, but they don’t have allergic disease. Their cellular machinery is activated in its proper context, fighting helminths.

34:18 Moises’ Parasite Experience: Moises went to Tijuana and purchased 30 necator americanus human hookworms. After consuming them, he felt bad at first. It is called the Worm Flu. His eczema went away. He has an autoimmune disease that makes him hairless, but with the worms, he started growing “peach fuzz”. He also lost his seasonal allergies for about half the season, but then the came back again. The worms did not give him constant immune suppression. Sometimes it felt like they were making things worse. Helminths could be both anti-allergenic and pro-allergenic.  While the parasite is alive, the immune system does not recognize it. However, when it becomes impaired or dies, the immune system detects it and can bring on a pro-allergenic response. The proteins within parasites are very pro-allergenic. It is the same proteins that are in cockroaches and dust mites. For Moises, the cons outweighed the pros. For others, especially with certain genetics or autoimmunity, it may be otherwise.

39:17 Autoimmune Disease is Not Your Fault: If you have autoimmunity, it is not your fault. It is a function of the environment changing much faster than we and our genome can change. The environment is completely different from the way we used to live as little as 150 years ago. Some of the genetic propensity to develop these diseases was good for us in the past. It helped us to survive.

42:01 Moises Favorite Herb or Nutrient:  Saccharomyces boulardii is his current curiosity. It is a form of yeast that makes you feel better. He also has an interest in an essential oil from lemon rinds called d-Limonene which helps with G.I. issues. It is very powerful. Eating well on a day to day basis is the most important thing.  Eat lots of vegetables and exercise. Intermittent fasting can activate cellular healing.

43:56 Moises’ Morning Routine: He has young children so the first few hours consist of feeding them and getting them to school.  Ideally, he would get up and do yoga and ride his kids to school on a bike.

44:52 One Health Tip for Americans:  When he wrote his book, Epidemic of Absence, he hoped that all of the different specialties represented in his book would get together and commit to solving the problem of autoimmune and allergic diseases in an interdisciplinary way.  He wanted them to figure out how to keep these diseases from emerging using an evolutionary perspective to replace lost stimuli.


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Interview Overview

Alanna Collen is a British science writer with degrees in biology from Imperial College London, and a PhD in evolutionary biology from University College London and the Zoological Society of London. She is a well-travelled zoologist, an expert in bat echolocation, and an accidental collector of tropical diseases.

During her scientific career, Alanna has written for the Sunday Times Magazine, as well as about wildlife for She has appeared on numerous radio and television programmes, including BBC Radio 4’s Tribes of Science and Saturday Live, and BBC One’s adventure-wildlife show Lost Land of the Volcano. She lives in Bedfordshire with her husband.

#107: Alanna Collen, PhD- Immunity, Autoimmunity and Gut Microbes

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