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99% Invisible
Drug Story: Ivermectin
00:48:26
What started as a revolutionary treatment for river blindness became something far messier.
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This episode is brought to you by PNC Bank. A lot of people think podcasts about architecture are boring. Yeah, okay, sometimes the details are boring, but that's what creates stable foundations and construction that lasts and that's something that everyone wants. It's like banking with PNC Bank. It might seem boring to save, plan and make calculated decisions with your bank, but keeping your money boring is what helps you live a more happily fulfilled life. PNC bank brilliantly boring since 1865 brilliantly boring since 1865 is a registered mark of the PNC Financial Services Group, Inc. PNC Bank National Association Member FDIC Lysol is known for proven disinfection and today it also delivers a clean that smells great, including a lavender scent. Lysol Disinfecting Wipes All Purpose Cleaner Spray and Power Toilet Bowl Cleaner clean and kill 99.9% of viruses and bacteria. The All Purpose cleaner can be used on hard, non porous surfaces in the kitchen and bathroom. Disinfecting wipes help clean everyday surfaces like remotes, tablets and smartphones. And the Power Toilet Bowl Cleaner disinfects both the toilet brush and bowl for two in one disinfection. Don't just clean Lysol clean. This is 99% invisible. I'm Roman Mars. For every disease, illness or discomfort, there is a drug. There are so many drugs. Drugs that seemingly work miracles and change the world, and drugs that are put in the service of fighting a malady for decades, only to learn much too late that they have almost no effect at all. You could tell the story of the world through the drugs we take and the diseases they are designed to manage. This is what the new podcast Drug Story is all about. On the show, creator and host Thomas Goetz tells the story of the disease business one drug at a time. Each episode explores one disease and one drug. Drugs end up being an incredible lens to view our world. This week we are featuring an episode of Drug Story, independent documentary journalism podcast. The kind of podcast you just don't hear about anymore, and one that deserves your full attention. It is so good. I've listened to every episode. Here's one of my favorites.
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Imagine living with constant itching that never stops or slowly losing your sight, not because of age, but because of a simple fly bite. That is the reality of onchocerciasis, also known as river blindness. One small tablet of ivermectin, taken once or twice a year, helps stop transmission and protects entire communities. This is how itching stops. This is how blindness is prevented. And this is How a generation grows up free from river blindness. Imagine that you are a worm, a very specific kind of worm. Unchocerca volvulus. Your goal in life, your mission, your only purpose, is to worm your way into the human body. You are a parasite. You need the human body to survive and to thrive. Humans, perhaps understandably, do not care for you. They curse you and your larvae. Your larvae especially, because once they get into humans, they squirm everywhere. They crawl into legs and they cause unbelievable itching, Horrible, infernal itching. And when they writhe into the eyes, humans go blind. For centuries, there was nothing humans could do but spite you. But then they found a pill, a horrible pill that kills your darlings. This pill, ivermectin, makes life very difficult for a parasite. Welcome to Drug Story. I'm Thomas Goetz. Today's drug is ivermectin, which truly is a wonder drug, a veritable miracle cure. It is really, really good at killing parasites that cause diseases like river blindness or elephantiasis. These tropical diseases mostly happen in Africa or South America or parts of Asia. Ivermectin is also effective against hookworm, which a century ago was endemic in the southern United States. And it's good on heartworm, which affects pets, dogs, and cats. And it kills parasites in horses or other livestock. But in the United States these days, you have probably heard of ivermectin, not as a treatment for river blindness, but. But for different purposes altogether.
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I just did a parasite cleanse. I never thought those words would come out of me. Things literally came out of me.
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I've used ivermectin when I was really sick. I had to. Yeah. And honestly, I actually think, you know, I've seen a lot of studies. I think that it's probably not a bad idea to use it once or twice a year to cleanse out of your body. Right, right. Some of my patients will take ivermectin as a prevention for viral illnesses. Totally fine, totally safe.
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I use ivermectin for 12, by 12, seven days, which is every 12 hours, 12 milligrams for seven days. And the reason is all the literature that's coming out about ivermectin as an anti cancer.
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You know, if you have a hidden
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parasite and how do you get rid of it? 30 recommend doing a parasitic detox, which
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you should talk to your own doctor
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about, because I am not licensed to practice medicine, but I do take a
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form of ivermectin and fenbendazole. So, yeah, Google tells me that right now there are many tens of thousands of videos on YouTube raving about ivermectin, but cancer, parasite cleanses and viruses. What is this drug? What does ivermectin do, really? In this episode of Drug Story, we're going to tell the story of Ivermectin, this amazing medicine. We are going to talk about parasites a lot, and we will dig into what got all those people on YouTube and Instagram talking about Ivermectin. But they hope it could be what they believe. It works on not just parasitic diseases, but viral diseases like Covid or even cancer, which would be great if there's, you know, evidence that it actually works for those other diseases. So we're going to explore that today with an open mind, an open notebook, and an open door to science. In the drug story ahead, we tell each episode in three the diagnosis, the prescription, and side effects. This is part one, the Diagnosis, where we explore the disease behind the drug, or in this case, the diseases. Because ivermectin is proven to work on many diseases, diseases with one thing in common. They are caused not by a bacteria or a virus, but by an animal, a parasite. Oftentimes, it's a type of worm called a helminth. Now, technically speaking, a parasite is an organism that lives inside or on another creature and feeds off of it. A tick is a parasite. So are lice, as is the tongue eating louse. That's this little crustacean. It's a relative of a shrimp that swims into a fish's gills, winds its way into the mouth and then eats the fish's tongue. Yeah. And get this, it then takes the place of that tongue. It lives there in the mouth, helping the fish eat, just as a tongue would. But taking a nibble of food every now and again. That, my friends, is a parasite. There are thousands, maybe millions of parasites on earth. Yeah, it just makes your skin crawl. In fact, there's actually a condition called delusional infestation, also called delusional parasitosis, where people are convinced that they have parasites. You might feel a bit of this right now, feeling like something is crawling on your skin, under your socks, maybe under your shirt. It's a little itchy. And no, a parasitic cleanse is not the answer. There is no evidence that those cleanses work. If you really think you have parasites, go see a doctor. Do not DIY this. Anyway, parasites have been worming their way into the human body for as long as there have been humans, even before, just as fish and birds and dogs and horses all get parasitic infections. So do we. Many of these parasitic diseases started in the tropics. Since about 1492, basically over the past 600 years of conquest and migration and slavery, parasitic diseases have spread around the world. Parasites are everywhere. Here's a factoid. The U.S. centers for Disease Control and Prevention is based in Atlanta, Georgia, because 75 years ago, parasitic diseases were common in the Deep South. It was mostly malaria, but also hookworm. In fact, let's start our tale there in the southern United States with a story about hookworms circa 1900. Charles Stiles was born in New York and educated in the zoological sciences at the finest institutions in Europe. Stiles was particularly interested in parasites in livestock, like trichinosis in swine and tapeworm in cattle. At the time, the study of parasites, this is called parasitology. This was a brand new field of medicine. Parasites, it was discovered, caused diseases like giardia and malaria. And compared to bacteria, parasites were easier to find, sometimes even visible to the naked eye without a microscope. But that did not make them any easier to deal with. So around 1900, Charles Stiles took a job as the chief zoologist for the U.S. public Health Service. And when he heard about health problems in the American south. Anemia, stunted growth, he had a hunch that parasites were involved. So Stiles began to research. Well, there's really no other way to say this. He went on a study of human shit across the South. He took stool samples from everyone willing to let him. And soon he had definitively identified hookworms as a cause of widespread malaise. Based on his poop studies, he estimated that around 40% of Southerners, whites and blacks, almost always poor, they carried hookworms. He called these parasites Necator americanus, which translates as American murderer. This was a misnomer, actually. People rarely die of hookworm infections. But hookworms did make daily life much, much worse. At the time, this was the first years of the 20th century. To be poor in the south meant almost no sanitation. No running water, no toilets, often no outhouses. People pooped well wherever, in the woods, behind bushes. And most poor people went without shoes, children especially. It was just easier that way. Shoes cost money. These were ideal conditions for the hookworm to prosper. Let's start in the dirt. Hookworm larvae live in the soil and burrow through to reach their target, human feet, where they quickly slip into the pores of bare skin. This might cause a rash. It was called ground itch. But the worm is in the larvae, which are super tiny, scarcely visible. To the human eye. They then wriggle their way into blood vessels and enter the bloodstream. And now the ride is on. The larvae flow to the heart and they are pumped out into the lungs. This usually causes a cough, which is just what the hookworm needs, because with every cough, the hookworm is forced out of the lungs into the mouth and then gulp, swallowed. And now the worm is home free. In the small intestine. The worm latches onto the intestinal wall. There it feeds on blood and grows to just half an inch long at most. From there, the adult worm produces more larvae, which are expelled with a stool into the dirt past the bush, where the worms wait for other feet to pass by. And so the cycle continues. But let's hook back. Sorry. To the adult worms, back in the intestines as they fester, sucking the blood out of their host. Hookworms cause anemia, that is a severe and chronic iron deficiency caused by blood loss. Symptoms of anemia are weakness and extreme fatigue. The English language is full of words to describe this. Indolence, sloth, lethargy, lassitude, laziness. In 1902, at the Pan American Sanitary Congress in Washington, D.C. charles Stiles announced his discovery. And he noted that there might be a connection between this hookworm, the American killer, and the characteristic state of Southern lassitude. And that became front page news. The headline in the New York sun screamed germ of laziness. Found at the time this stereotype of a lazy Southerner, especially white Southerners. It was commonplace as the north expanded in a frenzy of industrialization. The south was still overwhelmingly rural. Poor white Southerners were scorned as unmotivated and slow. And the stereotype lined up neatly with racial slurs about lazy black people. And that has been an even more enduring smear. So Charles Stiles had found his cause. But what about the cure? Once the germ for laziness headlines faded, no one seemed that interested in following up on Stiles work to do anything about the hookworms. It may have affected 40% of the population, sure, but hookworm was mostly an affliction of the very poor and often blacks. Remember, this was the Jim Crow era South, not a time of great progress. So this was just not a priority for the fledgling U.S. public Health Service or the growing nation. So Stiles started stumping and lecturing about what he thought should be done. He said, my hobby may be summarized in the two words clean up. In our filthy American habits of daily life, I see the cause of more preventable sickness and preventable death than I do in any other one factor. Eventually, in 1908, Stiles hooked up. Sorry with advisors to John D. Rockefeller, the founder of the Standard Oil Company and the richest person in the United States at the time. Rockefeller was interested in putting his wealth towards philanthropy, and Stiles work fit the bill. Soon there was a Rockefeller Sanitary Commission dedicated to eradicating hookworm in the southern United States. This would later become the Rockefeller Foundation. Stiles and the Rockefeller team identified three strategies to fight hookworm. First, infected people were to be treated with thymol. This was a naturally occurring chemical used as a disinfectant. And Epsom salt to kill and purge the worms. This involved a lot of vomiting and diarrhea, but it usually worked to rid a body of worms within 24 hours. Second, they went on an outhouse building campaign. One estimate at the time held that 35% of white households and 75% of black households had no privies. That would have to change. The goal was to build an outhouse for every home with a pit at least four feet deep. Third, shoes. Now, this was a big cultural change. Children in the south rarely wore shoes, especially in the summer. But shoes keep the worms out. The hookworm campaign quickly took off. State governments got engaged with Rockefeller money. Many southern states established sanitary commissions and better state departments of health. Soon there was talk of an expanded national public health service, one that could build on the success of the hookworm campaign and advance sanitation and healthcare across the land. The Rockefeller Coalition framed this as a movement for the conservation of country life. But they were really demanding that people change how they lived, where they lived, what they wore, how they ate. Change was the only way to keep disease at bay. And many people did not like all that change. Enter the National League of Medical Freedom. This opposition group condemned scientific medicine, arguing that people should be free to pursue whatever form of treatment they believed best and that the federal government should steer clear of endorsing certain kinds of medicine as more worthy than others. The League was funded by homeopaths, osteopaths and others in the alternative medicine business. At first, it worked. The League and a successor group, the American Medical Liberty League. They managed to delay approval of what was called the medical octopus, a stronger national health organization. But by the time of the New Deal and more effective drugs and treatments in the 1930s, the opposition faded. Though it did not disappear. That idea of defending medical freedoms against mainstream medicine, does that sound familiar? That idea would not die. It has not died. So now back to hookworm. That was eliminated in the southern U.S. more or less by the 1950s, though, it's not entirely gone from the south, and it still appears in dogs and cats and horses nationwide. And hookworm is still sadly common around the world. Which takes us to another worm. Let's follow our drug story to Africa to meet another parasitic disease, river blindness. In the villages of sub Saharan Africa, in countries like Ghana, Nigeria and Cameroon, people depend on rivers because that is where the food is, where the water is, that's where the work is. The water from the rivers is precious indeed, but the rivers are treacherous. They produce the black fly that brings blindness. That's from a 1983 documentary about river blindness. The black flies bite, and when they bite, they transmit the larvae of a worm called Onchocerca volvulus. The worm grows and breeds under the skin. The human body generally tolerates the adult worms with a low immune response. But when the baby worms, the larvae, get into the eye, a more intense immune reaction can cause inflammation and that leads to blindness. River blindness itself is rarely deadly to individuals, but it can prove fatal to a family or to a village. Because blindness often comes to men and women in their prime productive years. Sons or daughters must drop out of the workforce to care for a blind parent. Marriages and parenthood are less common. Eventually, young people flee the village. For decades, there was little to be done for onchocerciasis. As many as 20 million people were infected with the parasite worldwide. And hundreds of thousands were blinded or had impaired vision because of the disease. In the 1970s, the World bank began using DDT and other insecticides to kill black fly populations in West Africa. This worked in places, but it was terrifically dangerous to the environment and to human health. And then in 1981, a new drug appeared that might work for river blindness and for other parasitic diseases too, including hookworm. This was ivermectin and we'll get into that after a break in part two.
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welcome back to Drug Story. This is part two, the prescription, where we explore the creation and the use of a drug to treat disease. And today's drug is, of course, ivermectin. The creation of ivermectin begins, of all places, on a golf course south of Tokyo, Japan, in 1973. On the edge of the course, looking east over Sagami Bay, a young scientist named Satoshi Ohmura was digging up dirt. Now, at the time, it was well known that soil dirt was full of life and full of microbes. In any patch of earth, a war is going on with various bacteria producing chemical agents to kill off rival bacteria in the quest for food and survival. Since 1943, it was known that some of those microbes could be isolated and turned into medicines. One of the first antibiotics, streptomycin, was isolated out of soil. Tetracycline, rapamycin and a dozen other medicines started in dirt. Omura was a director at the Kita Sato Institute, and he had just begun a research project with Merck, the New Jersey based pharma company. Part of Omura's habit was to carry sample bags with him so that when the mood struck him, he could shovel up a soil sample for testing later. The sample from that golf course was just one of 40,000 cultures isolated in Omura's lab. The promising ones were then sent overseas to New Jersey. And exactly one turned out to have an antiparasitic effect. It killed worms. For the next few years, the Merck team, led by William Campbell, they sweated the stuff, trying to create a stronger brew of this microbe. They tested it against various pathogens, from bacteria to parasites. And after countless experiments, they had ivermectin, a drug that worked reliably and consistently to kill parasites in Livestock. In 1981, Ivermectin was approved for use in animals to kill various kinds of parasites. Mites and ticks and roundworms and hookworms and heartworms. Merck would make a lot of money this way. But parasites were also a problem in humans, particularly in less developed countries. So that same year in Senegal, Merck began testing ivermectin in people for the prevention and treatment of river blindness. And those experiments worked, too. Ivermectin was approved for use in humans in 1987. But who would pay for the drug? It would be no small expense to manufacture and distribute the drug to hundreds of millions of people worldwide. So Merck did something remarkable. The company agreed to give away the drug for free, as much as needed and as long as needed. As the company's chairman said at the time, within a few years, Ivermectin was being distributed to whole villages, whole countries. Soon, people started returning to the rivers in a land rush, as villages and communities were reborn with hope. And then another triumph. In the mid-1990s, ivermectin was proven effective for treating lymphatic filariasis, another widespread parasitic disease. In this case, worms. Delivered by a mosquito bite. This disease afflicts 100 million people and causes chronic swelling in the limbs and genitals, leading to horrible conditions like elephantiasis. Again, Merck donated the drug for free. Forty years after these triumphs, we now know that ivermectin works against a great many parasites. And it is easy to take just one or two pills a year. It gives countries a fighting chance to push back on disease and to reclaim land that has been abandoned due to infestation. To date, five countries have eliminated river blindness outright, and several more are really close. And all along, Merck has sold a drug under the brand name heartgard to prevent heartworms and hookworms in dogs. These products quickly became the top selling veterinary medicines in the world, earning more than $1 billion annually. So, yeah, Merck made their money, as they deserve to. And in 2015, Satoshi Amura and Merck's William Campbell were awarded the Nobel Prize in medicine for their discovery of ivermectin. Parasites are not generally regarded as being lovable when we refer to people as parasites, but we are not being complimentary. Here is Campbell accepting the honor? We tend to think that a parasite is the sort of person who goes through a revolving door on somebody else's push. This is unfair. It's unfair to real parasites, to the innumerable and influential parasites from the world of nature. Your majesties, your royal highnesses, your excellencies, ladies and gentlemen. It is Time for parasites to get a little more respect. We could end our story here. A miracle drug, a Nobel Prize. Millions of lives improved, billions of dollars earned. Somehow everyone is a winner. What a story. But that is not where this drug story ends. Because here our story takes a turn.
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Growing concern about a new and rare pneumonia like virus that has caused at least two deaths and has spread from China to other countries in Asia. The Centers for Disease Control and Prevention has confirmed the first US Case has been detected in Washington State.
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This is truly an unprecedented situation. This virus doesn't discriminate. It attacks everyone. I want every American to be prepared. In late 2019, a new disease emerged. Covid. And suddenly Ivermectin was front page news. I have today declared that the coronavirus
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presents a public health emergency in the United States. Public health emergency.
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A declaration of emergency, State of Emergency. COVID 19 can be characterized as a pandemic. We will be suspending all travel from Europe. I am officially declaring a national emergency.
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It was quite crowded and we had
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to wait outside for about 20 minutes before they let us in.
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Jumping to March 16th.
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This is part three. Side effects. Now, usually side effects are unwanted or undesired consequences of a drug. But sometimes those unintended consequences actually open the door to new uses for the drug. It's called repurposing.
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Repurposing for medicines is oftentimes a medicine may be developed for one reason, one indication, and it may have off target effects for a different disease process. So Viagra, everyone knows about Viagra. So Viagra was initially developed as a blood pressure medicine.
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This is Dr. David Bulwer, a professor of medicine and infectious disease physician at the University of Minnesota.
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It didn't really work that great as blood pressure medicine, but it had some off target side effects. So the side effects people were like, oh, this is a, this is a thing. So it was then repurposed for sort of erectile dysfunction. Even though it was originally developed as a blood pressure medicine. That's a famous example of something that's repurposed now.
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Remember when Covid hit the US in 2020, nobody knew anything. There was no obvious treatment. So there were a lot of ideas, some absurd ideas about what would work. Some people said bleach would kill the virus or methylene chloride, that's also known as paint stripper. Ultraviolet light was supposed to work in India. One politician held a cow urine drinking party and 200 people showed up. There were so many teas and salves and extracts and then there were supplements.
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People were crushing the store trying to get their hands on various supplements.
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This is Simone. She worked in a grocery store in Portland, Oregon. In the supplements section, she had a front row seat to the frenzy.
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Vitamin C, vitamin D, zinc, elderberry and nac. Oh, quercetin also.
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Right. And these all like help the immune system in theory.
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Yes. And the energy was very chaotic. Yeah, it was just a really weird time.
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And then there was the idea to repurpose drugs. Chloroquine and hydroxychloroquine and azithromycin. That's an antibiotic. It kills bacteria, not viruses like Covid. And then on April 4, 2020, ivermectin entered the conversation. The drug was first mentioned in a paper published in the journal antiviral research. Dr. Bolwer explains what the study said.
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There was a publication that came out that talked about how ivermectin had in a petri dish kind of lab situation where ivermectin had an anti viral effect against SARS CoV2. You put enough of anything in a petri dish in a high enough concentration, it will start inhibiting just cells and like kill, kill the cells. And so when I saw that, I was like, ooh. I was kind of, you know, I was interested and is that concentration achievable in the human body with. With normal dosings? And so when I did the mathematics kind of back the envelope calculation, it was like 100 times higher level than you would ever achieve in the human body. And within about five minutes realized like, this is unlikely to be a viable treatment option because the concentration needed for an antiviral effect is so high.
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So because it would kill the virus, but it would not be good for the human either.
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It's just so far beyond the normal dosing range that you would, to get that dose, you have to take a massive amount and you'd run into toxicity most likely. Because a lot of things work in a petri dish, a lot of things work in a mouse. Like, my gosh, we can cure cancer in a mouse, we can cure heart disease in a mouse. But it doesn't mean that whatever drug is always going to work in humans. But it's a starting point that you start there and then you've got to do a clinical trial to actually test it and see is there actually a benefit in actual humans with the disease.
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Now, Dr. Bulwer and others spotted this right away, that it would take a huge dose, a dangerously huge dose in humans to have the same effect. That was a pretty significant limitation, Basically a disqualifier but it was lost in the heat of the moment, and the media was all over this study. One headline said, ivermectin kills Covid in 48 hours. Newsweek wrote, Anti parasite drug used since 1980s may help stop coronavirus. New study says. Okay, that was not what the study said. But so it goes. Just days later, another paper appeared proposing even stronger evidence for ivermectin. This paper claimed it had data from a company called Surgisphere, based in Chicago. Supposedly, they had records from nearly 1,400 COVID patients from hospitals around the world. Half of these patients, the paper claimed, had been treated with ivermectin in the first days of the pandemic. Remarkably, the ivermectin patients showed a much lower lower mortality rate than patients who had not taken ivermectin. Just over 1% of the ivermectin patients died, compared to more than 8% of the non ivermectin patients. This was a staggering result. But the data was sloppy and inconsistent. And when other researchers asked to see it, the surgisphere researcher demurred, and he eventually disappeared. It was all fake, all made up. The doctor behind surgisphere, Sapan Desai, he was discredited. He holds the dubious honor of being among the first hustlers to try to exploit Covid for fame and fortune. The only trouble was that the headlines were already out there. These two papers and others published with fake surgisphere data, they have been cited by other researchers thousands of times. The damage was done. Here's a Senate hearing from December 2020 into, quote, unquote, hidden treatments for Covid, convened by the honorable Ron Johnson of Wisconsin. We are now in December. This is three to four months later. Mountains of data have emerged from all from many centers and countries around the world showing the miraculous effectiveness of ivermectin. It basically obliterates transmission of this virus. If you take it, you will not get sick. The speaker was a Wisconsin doctor named Pierre Cory. In August 2023, the American Board of Internal Medicine revoked Dr. Corey's board certifications for spreading false or inaccurate medical information. So what did those mountains of data actually say? Well, turns out Dr. Bulwer was among those doing the hard work away from the TV cameras.
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And I got involved with something called Activ6, which was a public private partnership sponsored by NIH and was run out of Duke as a co chair. So we looked at ivermectin, we looked at fluoxetine, we looked at inhaled steroids that are used for asthma, we did sort of the normal dose of ivermectin, 3 days of ivermectin early in treatment to see could you reduce the rate of hospitalization and could you get better faster. There were three trials I was involved with over 1,000 people per trial. And basically no statistical benefit over placebo. And no, like, you can't be like, oh, you just need more people because there was no benefits whatsoever. And so for me, like, after the first trial I was like, okay, I'm pretty convinced. And then the second trial is like, well, I'm pretty convinced. But then they say, oh, no higher dose. So, so we use a higher dose. And it's like, okay, third trial, higher dose, longer duration, and there was no benefit whatsoever. And so to me, I was, I mean, I thought that kind of closed the door on it. And that was in 2022, but still, like, people are still talking about it, still promoting it. And it's bizarre to me because it's one thing up front when we didn't know and there was some prelim data that suggests maybe this is beneficial. But like, you've got multiple trials, like, you kind of need to move on to something else. Usually for most physicians, like, I don't really have any vested interest in drug X or drug Y. I just want to know which one works better. And so, yeah, most people just kind of moved on, but some people were really kind of enamored with it and kind of stuck. Stuck with things that didn't make any sense scientifically long after the data suggested they should have moved on to something else.
- [41:04]
B
So no effect on the RCT placebo based trials, but they did see something interesting when they did not use a placebo. What's called an open label study, where you can actually see what you're taking.
- [41:17]
D
When you did an open label, what's from an open label study where they got an inhaler versus they got nothing. There was a benefit. And kind of psychologically, this also speaks to why if you give any medicine, particularly in Covid, where the vast majority of people are going to get better, people think they got better because they got the medicine. And so on the individual patient perspective, like, even if you give them medicine that doesn't have any benefit, they're going to feel better faster than if you give them nothing, which is kind of interesting. Instead of the placebo, Right? Yeah.
- [41:48]
B
So it is, it's a real effect. It's just not the medicine.
- [41:51]
D
It's not the medicine, but it's like you. Yeah. And it's it's like the power of thinking, but it's. Yeah, the placebo effect. So it's. So it's a real thing.
- [41:57]
B
This is an important finding because in the real world, this is how people were taking medicines, all sorts of medicines, including Ivermectin and open label. They saw the label, they took a dose, and a lot of them felt better. Here is Simone again. This is the woman who managed supplements at the Portland grocery store. She went to a naturopath with her husband before she got Covid.
- [42:21]
C
I knew that I wanted to have Ivermectin on hand, but it wasn't super easy to get a hold of. And he was able to get a prescription at a compounding pharmacy.
- [42:37]
B
Can you walk me through kind of what happened when you first got Covid?
- [42:40]
C
My husband had just had knee replacement surgery. And the next day is when I came down with COVID And so I was very out of it. For the first 24 hours, I literally just slept. By day three of the incredible body pain that I was experiencing. And within a couple hours of taking just the one pillow, I just felt amazingly improved. Probably, I don't know, 80% of the body pain had gone away. It was just pretty mind blowing, actually. I mean, I would take it again
- [43:31]
B
now. I want to say I appreciate Simone's perspective and her willingness to share her story. She did not have to, so I am grateful to her. And I think her experience shows how hard this is to figure out. She had Covid, she took Ivermectin, and she got better. She believes Ivermectin worked for her, and she has reason to. As Dr. Bulwer explained, sometimes it just works that way. But there is a difference between experience and evidence. And during a global crisis, it can be really difficult to let the science play out. To me, Covid was just a heartbreaking time, not just because of the million people in the US who died of the virus or the 7 million who died worldwide. What breaks my heart six years later is how Covid broke the trust between government and the citizens government should serve, between science and the people science is trying to help, between public health and. And the public. Covid was certainly not the only factor at work, but man, did it do a doozy on the trust people put in each other and in our institutions. It made it difficult for all of us to know, who can we count on? Who can we put our Faith in? In February 2021, Merck, that's the company that discovered Ivermectin, they put out a statement Saying that their scientists had reviewed all available research and they found that they identified no meaningful evidence for clinical activity or clinical efficacy in patients with COVID 19 disease. And this was Merck. They stood to make a lot of money if Ivermectin did work. And then in September 2021, there was a statement from the American Medical association and the American Pharmacists association strongly opposing the ordering, prescribing, or dispensing of Ivermectin to Prevent or treat COVID 19 outside of a clinical trial. Not only did they say it wasn't helpful, but that Ivermectin was demonstrated to be harmful to patients. But for those who had already lost faith in the medical establishment, this was probably just more fuel added to the fire of distrust. They wanted their medical freedom to do their own research and make their own choices. Now, I'm not going to chronicle everything that happened with COVID I'm not getting into vaccines or lockdowns or where the virus originated. That story is not this story. I will just note that in late 2021, YouTube decided to remove videos from their platform that contain dangerous coronavirus information. Over 1 million videos were removed. But there are still many videos there, thousands of them. And more still on TikTok or Instagram. And sometimes it just takes one video to get people talking again.
- [46:36]
A
I'll tell you a good story, okay?
- [46:40]
B
I have three friends. All three of them had stage four cancer.
- [46:45]
A
All three of them don't have cancer right now at all. And they had some serious stuff going on.
- [46:51]
B
What did they take?
- [46:54]
A
Jesus. They took some. What you've heard they've taken Ivermectin, Fenbendazole.
- [47:03]
B
Yeah, yeah, I'm hearing that a lot.
- [47:05]
A
They drank hydrochloride something or other.
- [47:08]
D
There's studies on those now where people
- [47:09]
B
have proven that people are drinking methyl blue and stuff. Yeah, methylene blue, which was a fabric dye. Yeah, yeah, it was a textile dye. And they find it has profound effects on your mitochondria. Yep. Yeah, this stuff works, man. There's a lot of stuff that does work, which is very strange because, again, it's profit. That was. Yes. Academy Award winner Mel Gibson and comedian Joe Rogan back in January 2025. More than 12 million people have watched that episode. Now, there is no evidence for any of that. In fact, there have been many, many studies looking into the potential therapeutic effects of ivermectin on various cancer, ovarian cancer, liver cancer, breast cancer, pancreatic cancer, lung cancer, and so on. Different cancers can have Very different courses in the human body. So drugs that work in one type often, very often do not work in another kind of cancer. Most of the research so far is in vitro in a petri dish. So the same caveats as above. What works in a petri dish or a mouse, it may not work in a human being. It may kill the cancer, but in amounts that could also kill the human. And none of these have been large scale randomized control trials in humans. So the data is scant, despite what Mel Gibson says. But what has changed is who was in charge back in Washington. And in February 2026, the new director of the National Institutes of Health, who has said the NIH should serve as the research arm of maha. Hey, everyone. I'm here today to tell you how we can make America healthy again. And the head of the National Cancer Institute Institute said that they had funded studies of ivermectin cancer treatments that are already underway. Here's what the head of the nih, if lots of people believe it and it's moving public health, we at NIH have an obligation again, to treat it seriously. Well, that's not actually the way it's supposed to work. Just because people believe something does not mean it's worthy of study or that it is worth the money, our money, to do the research. But whatever, that's the way they make decisions now. Studies are underway. Maybe it works. Who knows? And the great state of Florida isn't far behind. In late 2025, the Surgeon General of the Sunshine State announced a $60 million cancer innovation fund that would study, among other things, the value of ivermectin for cancer treatments. This is fine. It's what I have argued for in this show. After all, do the science, test your hypotheses. But like Dr. Bulwer explained, if it does not work, move on, find something better. Because even when you test something that doesn't work, you still get a lot of placebo effects. And each of those becomes an anecdote, a story, a testimonial. And to a lot of people, anecdotes are much more compelling than statistics and P values and relative risk reduction calculations. And we should expect a lot more anecdotes. Recently, five states, Tennessee, Arkansas, Idaho, Louisiana and Texas, have voted to make ivermectin available over the counter without a doctor's prescription. These states are not seeing an upsurge in hookworm or any river blindness. It's just for people who want it on hand, just in case, in the name of, yes, medical freedom. But Freedom's just another word for trying to sell you something. Just look at supplements. It's no coincidence that a lot of people promising unproven things have a product they want you to buy. This idea of evidence, of validity, it matters because when doctors or scientists say something doesn't work, they are not trying to deny people access to something. They're not trying to hide something. In fact, they're trying to find something, something that works. And they're generally trying to save people from wasting time and money and hope. And hope is particularly precious here because disease makes people desperate. And nothing is more valuable in desperate times than hope. That's it for this episode of Drug Story. For an annotated list of our sources for this episode, visit Drugstore Co. Drug Story was created, written and hosted by me, Thomas Goetz. Rachel Swaby is our producer and sound designer. Mark Bush is our engineer. Molly Warner is our research director. Drug Story was produced with support from the University of California, Berkeley School of Public Health. Thank you to our guests, Simone and Dr. David Bulwer. Drugstore Story is an independent production. If you would like to support our work, contact us at Drugstory Co. You can also subscribe to our substack there and be notified when new episodes come out. And I want to let you know we are gearing up for a season two. We have a lot more drug stories to tell. This episode of Drug Story might cause itching, scratching and googling of terms like delusional parasitosis. We recommend you wear shoes, wash your hands and grant your doctors and yourself a little more respect.
- [53:09]
A
You can listen to all of the first season of Drug Story at Drugstory Co. Go listen. It is fantastic. Season two is currently in production.
- [53:22]
B
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A
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B
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