Your Friendly Neighborhood Hookworms

Summary

Radiolab: "Your Friendly Neighborhood Hookworms" (May 15, 2026)

Overview

This Radiolab episode, hosted by Molly Webster and Latif Nasser, revisits and radically updates the show's iconic 2009 exploration of hookworms. The episode delves into the surprising and evolving relationship between humans and hookworms: from Southern sloth stereotypes and public health campaigns to modern research suggesting hookworm infection could treat autoimmune, metabolic, and allergic diseases. With new insights from clinical trials and researchers on the cutting edge, the episode asks: should we start thinking of hookworms as friends rather than foes?

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Key Discussion Points & Insights

1. A Historical Hookworm Tale

Origin Story and Eradication Efforts – 1900s South

• Rockefeller and the South: John D. Rockefeller funds a commission to investigate Southern “laziness.” Researchers discover much of the Southern workforce is anemic due to hookworm infection, traced to poor sanitation and barefoot exposure to contaminated soil.
  • [03:31] “The story I love telling the most is how we eradicated hookworm.”
  • [04:36] “So they asked these Southerners, when you guys defecate, where do you do it? ... Most of them said something like this, 'I defecate over there...'”
• Solution & Consequence: The invention and adoption of the outhouse (burying stool six feet deep) curtails the spread. Unintended bonus: declines in many other parasitic and infectious diseases.
  • [09:35] “We call that the outhouse. And in fact, Rockefeller got his wish. The south did rise again.”

2. Reframing the Villain: Hookworms as Potential Friends

Jasper Lawrence’s Self-Experiment and the Hygiene Hypothesis

• Jasper’s Story: Life-long allergy and asthma sufferer Jasper Lawrence learns of research connecting lower rates of autoimmune issues in developing countries with higher worm infections. He travels to Cameroon, deliberately infects himself with hookworms, and finds relief from his allergies and asthma.
  • [14:49] “I learned that asthma was 50% less likely in someone who had a hookworm infection.”
  • [17:22] “The day I realized that I no longer had allergies, that was such a good day... I just started screaming in the car. I was so, so happy.”
• The Science: Hookworms appear to dampen the immune system’s “attack” cells, potentially alleviating autoimmune and allergic conditions.
  • [19:23] “Somehow hookworms actually stimulate these cells which just quiet things down and tell the attack cells to stop attacking.”
• Hygiene Hypothesis: Rapid declines in worm infection due to improved hygiene may have unbalanced our immune systems, leading to more autoimmune disease in wealthy nations.
  • [20:39] “Yeah, this is called, they call it the hygiene hypothesis.” – Dr. Joel Weinstock

3. Modern Medicine and Hookworm Therapy: Trials, Risks, and Roadblocks

Jasper’s "Cowboy" Approach vs. Rigorous Clinical Studies

• Entrepreneurial Spirit: Jasper starts selling hookworm doses online, but this is unregulated and controversial. Scientific community urges caution, and notes the lack of FDA approval.
  • [24:00] “It’s a very sort of cowboy move to the scientific community. I think they believe that I'm premature.” — Jasper Lawrence
• Risks: Potential risks of hookworm (at high levels: anemia, diarrhea) but typically slow-onset and manageable.
• Clinical Studies Begin:
  • Prof. David Pritchard at University of Nottingham self-infects and conducts safety tests, finding that small doses are generally well-tolerated, but the therapeutic benefits remain to be proven in more rigorous trials.
    • [22:41] “We’ve now got two safety trials under our belts... But we’ve yet to conduct the trials to show that a therapeutic benefit results from infection with worm.” — David Pritchard

4. The 20-Year Hookworm Update: Human Studies Today

Dr. Paul Giacoman and Contemporary Clinical Trials

• Current Research: Dr. Paul Giacoman, (Australian Institute of Tropical Health and Medicine) runs clinical trials with carefully administered hookworm infections, exploring benefits for type 2 diabetes, celiac disease, and more.

  • [27:03] “Trying to understand the potential beneficial effects of worms in people.” — Dr. Paul Giacoman

• Worm “Farming” and Administration:

  • Hookworm eggs are collected from “worm farm” volunteers’ stool samples, disinfected, and placed on band-aids for participants — worms burrow painlessly through the skin and travel a complex route to the gut.
    • [29:38] “They put the worms on a band aid... and they put it on the skin of the patients.”
  • The worms’ journey is described as a “Mission Impossible” of tunnels, enzymes, and immune trickery.
    • [35:26] “It’s like Mission Impossible, on a worm scale... vault over this, but then say the right words...” — Latif Nasser

• Results:

  • In type 2 diabetes trials, participants with hookworms saw reduced blood glucose, increased insulin sensitivity, some even ceased to be prediabetic.
    • [36:12] “Some of these people who were considered prediabetic were no longer prediabetic.” — Molly Webster
    • [36:54] “At the end of this two year study, almost everyone kept their worms.”
  • Trials for celiac disease and other autoimmune conditions show improved mood, well-being, and sleep (“quality of life” gains).
    • [37:26] “This really interesting improvement in well-being and mood and sleeping quality.”

5. The Concept of the “Macrobiome”

• Beyond microbiomes (bacteria and viruses), Giacoman argues for recognizing larger co-evolved organisms—worms—as part of our health environment.
  • [38:15] “You know, the macrobiome, organisms that you can see with your naked eye, these worms...”
• The worm’s subtle modulation of the immune system, and potential wound-healing properties.
  • [34:29] “It’s in their best interest to basically feed and heal the wounds in their environment.” — Dr. Paul Giacoman

6. Why Aren’t We All on Worms?

Challenges to Mainstreaming

• Barriers: Social disgust (“ick factor”), technical hurdles (getting worms from stool “worm farms”), regulatory obstacles. Jasper ultimately flees the US under FDA pressure.
  • [42:02] “Making a medicinal product with standardization and decontamination, it’s just really hard.” — Dr. Paul Giacoman
  • [42:19] “Jasper...fled the US because they were being investigated by the fda.”
• The Future: Instead of live worms, researchers now seek to isolate and synthesize worm-derived proteins—turning them into medicines that could modulate the immune system or promote gut healing, without infection risks.
  • [42:32] “They’re trying to develop the proteins hookworms produce ... make them in a lab and then put them in pill form.”

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Notable Quotes, Moments, and Timestamps

• On Southern Stereotypes and Sanitation:

  • “When we stopped walking around in our own [excrement], all these unintended consequences.” — Jad Abumrad [10:07]

• On the Hygiene Hypothesis:

  • “We function like rainforests, we're ecosystems. And we've entirely eliminated a class of organism that co evolved with us...” — Jasper Lawrence [20:45]

• On the Mutually Beneficial Evolution:

  • “So there’s this really interesting truce that’s happened throughout evolution where the worm benefits and the host benefits.” — Dr. Paul Giacoman [40:30]

• On Public Perception and Future Therapy:

  • “Everyone is kind of like, listen, there’s so many reasons why people don’t want worms. Like, they’re kind of just gross.” — Dr. Paul Giacoman [41:48]
  • “If I was you and I was in pain, I would try and figure out how to get a worm or get into a clinical trial. Can you fly to Australia...?” — Molly Webster [43:17]

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Timeline of Major Segments

• [00:08–01:36]: Molly and Latif set up the hookworm revisit—original story and tease of the update
• [03:00–11:00]: The Southern “laziness,” Rockefeller’s commission, and discovery of hookworm’s impact
• [12:00–24:48]: Jasper Lawrence’s self-infection saga; discussion of the hygiene hypothesis and immune regulation
• [26:14–43:09]: Molly and Latif jump to the modern era; clinical trials for hookworm therapy, explained via Dr. Paul Giacoman’s research; discussion of results, hurdles, and directions for future therapy
• [43:17–44:06]: Practical considerations; would Latif or others try worms today? Geographic and regulatory barriers discussed

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Summary Takeaways

• Hookworm, once vilified as a cause of mass ill health, may paradoxically provide benefits—especially in preventing or managing autoimmune and metabolic diseases—due to their immune-dampening capabilities.
• Modern clinical trials show promising results in humans: participants with hookworm infections achieved significant improvements in insulin resistance, mood, and well-being, with few side effects at low doses.
• The biggest barriers to “worm therapy” are not efficacy, but public squeamishness, technical difficulties of production, and regulatory acceptance.
• The future may belong to synthetic “worm proteins” rather than live hookworms, allowing medicine to deliver the benefits without the ick.

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For Listeners Considering Hookworm Therapy

Despite the promising science, self-infection remains risky, unregulated, and unapproved. If considering experimental therapies, seek out legitimate clinical trials rather than the black market, and be aware of both medical and ethical complexities.

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Further Listening

For more context, check out Radiolab’s original 2009 “Parasites” episode, also available on their website.

Transcript

[Latif Nasser]

Hey, I'm Latif Nasser.

[Molly Webster]

Hi, I'm Molly Webster and this is Radiolab.

[Latif Nasser]

And what are we doing today, Molly?

[Molly Webster]

Okay, well, Latif, remember back in 2009, before you and I both worked at the show, there was an episode called Parasites.

[Latif Nasser]

Oh, my God. Love that episode.

[Molly Webster]

It is really one of my favorites. And in that episode, we talk about this tiny, maybe creepy little worm called a hookworm.

[Latif Nasser]

That's right.

[Molly Webster]

You remember it?

[Latif Nasser]

Yeah, I mean, like, it hooked into my brain. Like the.

[Molly Webster]

The hookworm hooked into your brain.

[Latif Nasser]

It's the story of that one guy. And then there's the final scene where he's walking through the.

[Molly Webster]

Oh, wait, okay, wait, wait, wait. You don't actually have to tell. Don't. Don't say what the final scene is, is, because what we're going to do here is I'm going to play this the hookworms chunk of that episode, and then I have an update a 20 year later hookworm and human medical update

[Latif Nasser]

VH1 behind the Music. Where is the hookworm now?

[Jad Abumrad]

Yes.

[Molly Webster]

Where is the hookworm? And where is the human.

[Latif Nasser]

Okay, great.

[Molly Webster]

This whole episode, it introduced this idea that this thing that we think is like the biggest, scariest, grossest pest of all time, maybe they're not as gross as you think. And now 20 years later, people are saying maybe they're really not as gross as you think.

[Latif Nasser]

Love it.

[Molly Webster]

And there's just like, all this cool new research about hookworms in the human body and specifically one very important type of disease, Autoimmune disorders.

[Dr. Paul Giacoman]

Ooh.

[Latif Nasser]

That, as you know, is one I'm particularly interested in, but. Well, yeah, I'm sold. I would like to hear more.

[Molly Webster]

Okay, great. So I'm gonna play the original hookworm segment just so we all know what's going on, and then we'll jump into an Update in about 20 minutes.

[Latif Nasser]

Okay, great. Wait, you're listening.

[Jasper Lawrence]

Okay.

[Pat Walters]

All right.

[Molly Webster]

Okay.

[Jad Abumrad]

All right.

[Molly Webster]

You're listening to Radiolab.

[Pat Walters]

Radiolab from wnyc.

[Molly Webster]

Rewind.

[Jad Abumrad]

Hello, I'm Jad Abumra.

[Robert Krulwich]

And I'm Robert Krilwich.

[Jad Abumrad]

This is Radiolab. Our topic today, parasites. Parasites.

[Robert Krulwich]

Now, we've met them, they're nice, and we've met them when they're not so nice.

[Jad Abumrad]

I don't know that we've met any nice ones, really.

[Robert Krulwich]

Oh, we haven't. I thought that. Oh, they're those flukes.

[Jad Abumrad]

They were pretty nice. Yeah, they were nice.

[Robert Krulwich]

So now the question is, let's just talk about scale. I mean, for the most part, they're Irritating and little. And they seem kind of invisible. Invisible and sort of offstage.

[Jad Abumrad]

Yeah.

[Robert Krulwich]

But when you back off a little bit and consider them, you know, in the effects that they have on the

[Jad Abumrad]

world, they're actually these powerful sculptors of monumental narrative.

[Robert Krulwich]

In other words, these are little guys telling very big stories.

[Jad Abumrad]

In fact, here's an example. Recently I went to visit a guy named Dixon Despamier, but Columbia University, he's a parasitologist and, well, he does a bunch of different things. We ended up talking about. Well, he told me this crazy story.

[Molly Webster]

Okay, Molly, jumping in here really quick. This next part of the story which has to do with Rockefeller, think of it like those stories that has been told so many times. It starts to become like a tall tale. It's a living myth. So the facts are a little blurry, but the idea is right. Here we go.

[Unknown Rockefeller Commission Member]

The story I love telling the most is how we eradicated hookworm.

[Jad Abumrad]

The story begins in 1908.

[Unknown Rockefeller Commission Member]

John D. Rockefeller, Sr. Really Rich Guy,

[Jad Abumrad]

is sitting in his New York office

[Unknown Rockefeller Commission Member]

and he's thinking, how can I make more money selling something to the South?

[Jad Abumrad]

Yeah. I've got all this money, got all these resources. I just need a new market. In terms of new markets, the south was pretty much untapped. If only those damn Southerners would just

[Unknown Rockefeller Commission Member]

get off their butts and get going.

[Jad Abumrad]

Problem was, they weren't. They weren't getting off their butts.

[Unknown Rockefeller Commission Member]

The farms were not operational. The economic engine was turned off.

[Jad Abumrad]

The economy was in the toilet. And so John D. Rockefeller wanted to know why. Why aren't they producing more?

[Unknown Rockefeller Commission Member]

Yep. What's happened to their economic engine? So he thought, I know, I'll form a commission.

[Jad Abumrad]

Yeah.

[Unknown Rockefeller Commission Member]

So he sent out a bunch of economists and sociologists and people like that on the original Rockefeller commission. They did everything a commission could possibly do to try to find out why these Southern gentlemen were not rising to the occasion. And they came back with the following conclusion. Well, we. We don't exactly know what's wrong, but we think that these people are sick from something because they don't. They don't behave like we do.

[Jad Abumrad]

What does that mean?

[Unknown Rockefeller Commission Member]

They are slow. Not mentally. They're slow physically. They're pale. I'll give you an example. Remember the movie Deliverance?

[Jad Abumrad]

Sure.

[Unknown Rockefeller Commission Member]

Okay. Remember that little guy that played the banjo?

[Jad Abumrad]

I remember the other scene that we all read. We're not gonna talk about that.

[Unknown Rockefeller Commission Member]

No, we're not. No, we're not. But if you can recall what that little banjo player looked like. Little wiry looking guy.

[Jad Abumrad]

But he looked old, sickly pale.

[Unknown Rockefeller Commission Member]

Yeah, sickly pale and yet an adult.

[Robert Krulwich]

Well, wait a second, wait a second. That is not a description of all Southerners. No description of one teeny corner in a.

[Jad Abumrad]

No, but what the commission did say about a lot of these Southern people that they encountered is that a lot of them, they just don't look right. They look weak. They looked wan. They looked kind of wan. Wan, wan, wan. They were wan, Pale, lethargic.

[Robert Krulwich]

It's interesting. Wan or wan, wan.

[Joel Weinstock]

Yoochoo.

[Jad Abumrad]

So the thought was that maybe these Southerners had some kind of laziness to. This is really what a lot of folks thought. But one member on the committee suggested to Rockefeller, you know what? Perhaps these people are anemic.

[Unknown Rockefeller Commission Member]

Anemic. They're anemic. Do you say, yeah, they're anemic. It sounds like a medical problem. Then maybe they're not lazy after all. Maybe they're anemic and maybe they're just weak.

[Jad Abumrad]

Next thing you know, Rockefeller puts together another commission to find out what the

[Unknown Rockefeller Commission Member]

basis for the anemia was. And not only did they find anemia, but they found a correlation of the anemia with soil types. That's bizarre. Sandy loamy soils. Anemia. Hard packed clay soils. No anemia. Sandy loamy soils, good farmland. Hard packed clay soils, not such good farmland. So all the rich farmers were anemic and all the poor farmers were doing okay.

[Jad Abumrad]

And this seemed to be a clue. The incidence of anemia was linked somehow to the soil.

[Unknown Rockefeller Commission Member]

Maybe.

[Jad Abumrad]

Bum, bum, bum.

[Pat Walters]

Yes.

[Jad Abumrad]

Something was in the soil.

[Unknown Rockefeller Commission Member]

That's correct. So somehow they hit upon this idea of looking for a hookworm.

[Jad Abumrad]

The hookworm.

[Unknown Rockefeller Commission Member]

The hookworm.

[Jad Abumrad]

So they thought, all right, let's run some tests.

[Unknown Rockefeller Commission Member]

And when they did big time, they discovered hookworm. Big time. So the anemia is due to hookworm.

[Jad Abumrad]

Now the question became, how are these Southerners getting the hookworm and giving it to one another? And a pretty good place to start to look for an answer was their feces. Because if these hookworms are in you, they're gonna come out of you when you go to the bathroom. So they asked these Southerners, when you guys defecate, where do you do it? Most of them said something like this,

[Unknown Rockefeller Commission Member]

and I defecate over there. You see that tree over there? That's where I defecate. So I defecate over there, but I live over here.

[Jad Abumrad]

Okay? So then the investigators asked the next question. When you go to that tree and do it, do you. Do you wear any shoes? Most of them said no.

[Unknown Rockefeller Commission Member]

Barefoot, just like everybody else, because it's comfortable.

[Jad Abumrad]

So clearly these worms are in the feces that are landing near the tree, that are somehow getting into people's feet the next time they come to use the tree. But no one intentionally steps in their own. You know, no one does that.

[Unknown Rockefeller Commission Member]

Which meant, oh my goodness. Oh my goodness. It can crawl, right? So let's find out how far it can crawl.

[Jad Abumrad]

So what they did, these researchers, is they built a sandbox and then they took some hookworm infested stool and put

[Unknown Rockefeller Commission Member]

it right in the middle. Then every day we'll sample from the stool sample out in the sand in all directions and find larvae and find out how far they can try travel. How's that sound? So now we have larvae in the stool, and they began to crawl away from the stool, seeking a victim. On day one, they crawled an entire foot in all directions. But they weren't at 2ft on day two. My God, they're at 2ft. At day three, they're at 3ft. I can't believe this. They're crawling a long way. Day four, they crawl to four feet.

[Jad Abumrad]

What about day five?

[Unknown Rockefeller Commission Member]

I'm allowed to ask that. And what about day five?

[Jad Abumrad]

Five feet? No, no, four feet.

[Unknown Rockefeller Commission Member]

That's it. So how in the world could you deal with this problem when these worms can crawl, they can crawl four feet. It doesn't matter where you defecate, they're going to crawl away from that. And within a four foot radius of that stool sample, you're going to get hookworm. Unless you do something radical that's never been done before. They devised a scheme for burying the stool sample into the ground six feet deep.

[Jad Abumrad]

Because if the worms can only make it four feet, well, then that's two feet past the point where they die.

[Unknown Rockefeller Commission Member]

We call that the outhouse. And in fact, Rockefeller got his wish. The south did rise again.

[Jad Abumrad]

That sounds too easy to me, though. You're telling me that an understanding of hookworm which created the outhouse, removed the, quote, southern laziness disease, and they did rise.

[Unknown Rockefeller Commission Member]

It did.

[Jad Abumrad]

And you bring that all back to the hookworm?

[Unknown Rockefeller Commission Member]

I do.

[Molly Webster]

Really?

[Unknown Rockefeller Commission Member]

No, I bring it back to sanitation.

[Jad Abumrad]

Now, to be fair, you can find plenty of other reasons why the south rose again.

[Robert Krulwich]

Air conditioning and highways and universities and stuff like that.

[Jad Abumrad]

So the hookworm had some. But what is clear is that when we as a country began to distance ourselves from our own excrement, to put it bluntly, when we stopped walking around in our own, there were all of these unintended consequences.

[Unknown Rockefeller Commission Member]

Salmonella Disappeared. Izlitica, disappeared. Shigella disappeared. Cholera, disappeared. Giardia, disappeared. Cryptosporidium. Anything that's associated with parasites and feces disappeared. Every time we build out houses and people use them religiously, guess what? Their kids could stay in school longer. They could learn more. They got ahead faster.

[Jad Abumrad]

Dixon Dasvamier is a professor of public health in environmental health sciences and microbiology at Columbia University.

[Robert Krulwich]

Can they make longer titles at that university?

[Jad Abumrad]

He literally wrote the book on parasites.

[Robert Krulwich]

The book is called Parasitic Diseases. You know it very well, and it's soon to be a major motion picture, but now in its fourth edition.

[Jad Abumrad]

In its fourth edition.

[Robert Krulwich]

And while we're on the subject of hookworms and the glorious campaign to deworm America, because this has been a very carefully crafted and intentionally fair program, you have heard the case against hookworms. Now let's turn the coin and say something nice about hookworms. And to begin that discussion, let's go to our reporter, Patrick Walters. So, Pat, are you there?

[Pat Walters]

Yeah, I'm here, Robert.

[Robert Krulwich]

So tell us a little bit about this fellow. What's his name exactly?

[Pat Walters]

His name is Jasper Lawrence.

[Jasper Lawrence]

That's right, Jasper Lawrence.

[Robert Krulwich]

So where is he from?

[Pat Walters]

He actually grew up in England. He grew up in this little farm in the southwest corner of England. It's important to know, I think, before hearing any part of his story, that Jasper has had allergies for pretty much his whole life.

[Jasper Lawrence]

On really bad days, my eyes would swell up so much from pollen or airborne allergens that they would feel like they were swelling shut. I could feel my eyes squeaking in my sockets. It was an enormously uncomfortable feeling, but

[Pat Walters]

it was nothing debilitating.

[Jasper Lawrence]

They were just allergies.

[Pat Walters]

So, you know, he's just like most other people have allergies. Just learn to deal with it, you

[Jasper Lawrence]

know, you live with it. But what changed for me in my late 20s, early 30s was my asthma. And at that time, I was living in Santa Cruz. I was relatively recently married. We had three cats that had been grandfathered in with the relationship, and I started a landscaping business. I really didn't want to work for someone else anymore.

[Pat Walters]

I was thinking someone with allergies starting a landscaping business, that seems kind of unexpected.

[Jasper Lawrence]

Stupid is actually the word for it. And within six months or a year, he starts to notice this really weird barking cough.

[Pat Walters]

Was there anything particular that brought this on?

[Jasper Lawrence]

No, it was just sitting and breathing. Cats certainly didn't help. And during that period, my asthma got much worse very, very quickly. By the time it was 1996, 1997, I was seeing specialists having skin allergen tests and cycling through emergency inhalers, trying Singulair and all these other drugs that were coming on the market. I was being hospitalized at least a couple of times a year. I mean, I looked terrible. I had dark eyes and pale, waxy skin. I had that allergic look. It was a really bad time.

[Pat Walters]

And he decides in the summer of 2004 to take a vacation. You made this visit to England?

[Jasper Lawrence]

Yeah. I took my two daughters back to see my aunt who had raised me. Very early in the visit, I was sitting at her kitchen table and she asked me if I'd seen a BBC documentary about parasites and their connection with things like asthma and allergies, multiple sclerosis. And of course I hadn't. But I went upstairs and got on the Internet after lunch, and I stayed on the Internet until perhaps two in the morning. I didn't stop.

[Pat Walters]

And he's reading and reading.

[Jasper Lawrence]

And the work of all these researchers,

[Pat Walters]

one study after the next, Japan, epidemiological

[Jasper Lawrence]

studies in Africa, animal models of multiple sclerosis. This enormous weight

[Pat Walters]

of evidence that in the developing world, people don't really have asthma or allergies. And what he discovers is that behind all of this, to his shock, is hookworms.

[Robert Krulwich]

Hookworm? Yeah.

[Jasper Lawrence]

Hookworms, Yeah. I learned that asthma was 50% less likely in someone who had a hookworm infection.

[Pat Walters]

So this sort of just like, hits you.

[Jasper Lawrence]

Oh, yeah.

[Pat Walters]

What did you think when you. When you read that?

[Jasper Lawrence]

Oh, I immediately was determined to obtain hookworm. Immediately. I couldn't wait.

[Pat Walters]

So hookworms are these very tiny worms, the size of a little hair, but if you take a microscope and you zoom way in, they have this big circular mouth, brimming, full of pointy teeth. Very scary to look at. They have these toothy mouths so that they can burrow up through your feet, ride through your blood, and eventually end up down in your gut and start chewing on the inside of your intestines.

[Robert Krulwich]

This guy wants hookworms in his intestines?

[Pat Walters]

Absolutely. And so you just Google it.

[Robert Krulwich]

Yeah.

[Jasper Lawrence]

Hookworms for sale. I mean, you know, someone's gotta be selling them, but not nothing. I contacted every laboratory supply company in the world and parasitology research centers, and they all said the same thing, various flavors of no. And so I came to the conclusion that I was going to have to go to the tropics.

[Pat Walters]

So fast forward a little. Jasper is in Cameroon, along the coast,

[Jasper Lawrence]

quite literally and figuratively the armpit of Africa.

[Pat Walters]

He's 200 miles north of the equator. It's extremely hot. He finds a guy to drive him around, and so he and his driver would go to a village, get out of the car, walk up to these villagers and ask them if they could see the latrine.

[Jasper Lawrence]

Just an open area of ground, usually with bushes so people can have a little bit of privacy. And I would go over to the area, remove my shoes, and start walking. The first time I did that, I almost couldn't do. Must have been 110 degrees that day. 100% humidity. And the stench and the noise from the insects, it was so repulsive and so disgusting.

[Pat Walters]

How many villages of latrines do you think you visited?

[Jasper Lawrence]

Between 30 and 40.

[Pat Walters]

Jasper spent two weeks. They're walking around in village latrines, and then he flew home.

[Jasper Lawrence]

I got back from Africa in early February, so I was looking at allergy season coming up. And the day I realized that I no longer had allergies, that was such a good day. I got into my car and I started driving, and I had the window down. You know, I felt the breeze blowing across my face. In the past, what that meant was that very quickly my eyes would be itching uncontrollably. Snot and phlegm was gonna be pouring out of every orifice in my face. And it didn't happen. It didn't happen. I just started screaming in the car. I was so, so happy.

[Molly Webster]

A word up. Word up. Word.

[Jad Abumrad]

A word.

[Jasper Lawrence]

And I haven't had an asthma attack since I went to Africa. I no longer have allergies. The vast majority of the benefit that I've experienced has come from hookworm.

[Robert Krulwich]

What is the hookworm doing? Do you know?

[Pat Walters]

Well, so the immune system that we learn about in elementary school is all about, like, these attack cells that go after foreign invaders and destroy them. And that's a big important part of the immune system. But if the immune system were allowed to attack and destroy things unchecked, it could kill you. And there are lots of diseases where the primary symptoms are caused by the immune system attacking the body that it's really designed to protect. Allergies and asthma are just two of these. Some of the more serious ones are like type 1 diabetes, multiple sclerosis, Crohn's disease, in which the immune system actually starts attacking the inside of the intestines. There are like 80 of these diseases.

[Robert Krulwich]

80 of them.

[Pat Walters]

So what scientists have found in lots and lots of mouse studies and in some human studies to this point, too, is that once the hookworms get inside the gut and the immune system actually starts attacking. Somehow hookworms actually stimulate these cells

[Unknown Rockefeller Commission Member]

which

[Pat Walters]

just quiet things down and tell the attack cells to stop attacking.

[Robert Krulwich]

So these are like lullaby cells.

[Pat Walters]

Exactly. What lots and lots of scientists think,

[Joel Weinstock]

Joel Weinstock, Joel Weinstock Tufts Medical center

[Pat Walters]

and dozens of others, is that over

[Joel Weinstock]

thousands and thousands of years, hookworms almost

[Pat Walters]

developed in tandem with the human immune system.

[Joel Weinstock]

Coevolution parasites living within your body. Your immune system changes.

[Pat Walters]

So you got to a point where the hookworms could survive safely.

[Joel Weinstock]

Worm gets a home. There's food coming down the food pipe.

[Pat Walters]

And in return, the human immune system gained some kind of, some form of positive regulatory advantage. So that if you had this glitch where your immune system started attacking your own body, the presence of the hookworms would keep things controlled.

[Joel Weinstock]

That's the gift. You do something for the worm, the worm does something for you.

[Robert Krulwich]

So then by that logic, what we in the west, in the richer countries have done stupidly, is we have cleaned ourselves up too much and we don't have enough wormies in us.

[Joel Weinstock]

Yeah, this is called, they call it the hygiene hypothesis.

[Robert Krulwich]

The hygiene hypothesis that we are not dirty enough.

[Pat Walters]

Too clean.

[Jasper Lawrence]

We function like rainforests, we're ecosystems. And we've entirely eliminated a class of organism that co evolved with us and our genetic predecessors for millions of years now.

[Joel Weinstock]

I don't want to leave the impression that hygiene is bad for you. People can't go back to living in filth, kids playing in sewage by the riverbank. But in improving our hygiene, we are also excluding organisms that may be important for making us well.

[Robert Krulwich]

So then what does Jasper do about all this?

[Pat Walters]

He decides to start a business selling hookworm to people.

[Jad Abumrad]

What?

[Pat Walters]

You can call him up and he will literally FedEx a dose of hookworms to your door.

[Robert Krulwich]

How.

[Jad Abumrad]

Sorry to break in for a second, Pat.

[Pat Walters]

Hi, Jad.

[Jad Abumrad]

Where does he get the hookworm from?

[Pat Walters]

This is weird. Jasper gets the hookworm from himself. Could you describe how you go about getting hookworm from your stool into one of your patients?

[Jasper Lawrence]

Well, it's a very easy organism to work with. It just, it gets up and it walks out of it. So it doesn't take an enormous amount of work to separate it from the feces. And then having done that, I repeatedly wash them in solutions of antibiotics to make sure that anything that could live on them is killed. People contact us, we'll have them complete a questionnaire, submit a recent blood test, then we'll ship them a dose and all the materials and equipment and the instructions necessary to infect themselves.

[Robert Krulwich]

Is this a safe thing to do, to suggest Jasper?

[Pat Walters]

Jasper has done tons and tons of research, but he's not a doctor. The treatment is not approved by the fda.

[Robert Krulwich]

That's what I wonder, is there any serious sort of double blind study trying to figure out whether some safe delivery of hookworm might make sense?

[Pat Walters]

Yeah. So one of the guys who was sort of a pioneer in this hookworm research is David Pritchard. I'm Professor David Pritchard, immunologist and parasitologist

[David Pritchard]

at the University of Nottingham, where I study parasites and the wound healing properties of maggots. So we've now got two safety trials under our belts, but we've yet to conduct the trials to show that therapeutic benefit results from infection with worm.

[Pat Walters]

So Pritchard infected himself pretty much just to make sure that it was safe.

[David Pritchard]

What we did was 10 of us in the lab took worms at different doses. We were either given 10, 25, 50 or 100 worms. And then we had to report on the symptoms. And on the back of that study, we determined that 10 worms were tolerated.

[Pat Walters]

But Pritchard, when he did this proof of safety study, actually gave himself 50 hookworms.

[Latif Nasser]

Oh.

[Pat Walters]

Which put him out of commission for a while.

[David Pritchard]

Well, I felt pretty bad. I mean, pain in the gut, really. You could feel them because they are biting on your tissues.

[Pat Walters]

I mean, if you have too many hookworms, they can cause things like diarrhea. And the most serious side effect, and the side effect that makes them sort of a public health enemy is that they can give you anemia.

[David Pritchard]

So if you have too many, you lose quite a bit of blood to these parasites.

[Jasper Lawrence]

Well, you know, if you take too many hookworm, which you're not gonna. If you come to us, the worst thing you're gonna get is anemia. But it's not like you wake up one morning and you're drained of blood, very slow to develop, and it's very easy to deal with.

[Pat Walters]

Jasper's kind of just gone for it. You know, it's a very sort of

[Jasper Lawrence]

like, cowboy move to the scientific community. I think they believe that I'm premature.

[Joel Weinstock]

It's not FDA approved.

[Jasper Lawrence]

In offering this to the public, you

[Joel Weinstock]

don't know what it is. You don't know its purity. It's not safe.

[Pat Walters]

But I've talked to several clients who had really severe allergies and asthma. They say they've just achieved these great results. And Jasper also says he's seen success with a few multiple sclerosis patients and several Crohn's disease patients, too. Like, how many people do you think that you have infected?

[Jasper Lawrence]

It's about 85 right now.

[Pat Walters]

How is business?

[Jasper Lawrence]

Is it everything? That business is adequate. But I honestly don't know why I don't wake up in the morning with my front garden 20 deep with people with ulcerative colitis, Crohn's disease, allergies. I just don't know why I'm not completely buried.

[Pat Walters]

The way he sees it, people are scared.

[Jasper Lawrence]

Well, there are the people who are coming from a point of view of what they learned in kindergarten about clean drinking water and sewers. To them, worms and parasites are so repulsive that there's nothing good to be said about them. But I can make you better. It's simple. It's cheap. I mean, for God's sake, these organisms fall out my rear end every day, a half a million at a time. The raw material is human excrement, for God's sake. All people have to do is open their minds. Are you really that scared of a little worm?

[Latif Nasser]

Okay, okay, okay, okay.

[Molly Webster]

So, okay, so that's it.

[Latif Nasser]

So, so, wait.

[Dr. Paul Giacoman]

But.

[Molly Webster]

Okay, yeah, maybe the. Maybe the question is, Latif, you have talked about this on the show. You have an autoimmune disorder.

[Latif Nasser]

Yes.

[Molly Webster]

Crohn's disease.

[Latif Nasser]

Crohn's disease.

[Molly Webster]

Okay, you've heard this piece. Are you scared of a little worm?

[Latif Nasser]

I mean, I am intrigued. I don't know whether to be scared. If there are clinical trials that can help tell me whether to be scared or not of this worm. That's what I want to know.

[Molly Webster]

All right, well, then I am going to tell you about a clinical trial, and then you can tell me what you think. But after the break, all right.

[Latif Nasser]

Oh, after the break. All right, after the break. Let's do it.

[Molly Webster]

Clinical trial.

[Latif Nasser]

I'm ready. I'm excited.

[Molly Webster]

Okay, great. Latif, we are back from break, and we left you at Are you scared of a little worm?

[Latif Nasser]

And I was like, maybe. Maybe. I don't know. Let's do some actual clinical trials.

[Molly Webster]

And that is what, like, okay, so that episode was done in 2009.

[Latif Nasser]

Right.

[Molly Webster]

And so I want to fast forward to today. There have been a number of clinical trials.

[Pat Walters]

Oh, it's so exciting.

[Latif Nasser]

Okay, so what happened?

[Molly Webster]

Okay, so. Hi.

[Dr. Paul Giacoman]

Hey, how are you? I talked to this researcher, Dr. Paul Giacoman. Paul Jackman, senior research fellow at the Australian Institute of Tropical Health and Medicine.

[Molly Webster]

And he's basically trying to do, like, the next iteration of Jasper. Of, like, Jasper, but, like, With. With actual scientific studies and stuff.

[Dr. Paul Giacoman]

Okay. Yeah, yeah. Trying to understand the potential beneficial effects of worms in people.

[Molly Webster]

So one of the things that he's been studying is treating people who are

[Dr. Paul Giacoman]

at risk of type 2 diabetes with hookworms.

[Molly Webster]

So type 2 diabetes, that's the diabetes you typically. Later in life.

[Latif Nasser]

Yeah.

[Molly Webster]

What made you pick diabetes?

[Dr. Paul Giacoman]

It sort of came on the back of research, which started in the 2010s, where people went into regions of the world where parasitic worms are really common.

[Molly Webster]

And what they found is that there is a correlation between something like type 2 diabetes and the presence or lack of worms.

[Latif Nasser]

Huh.

[Dr. Paul Giacoman]

Yeah. So basically.

[Molly Webster]

So what Paul and his team did is basically they took people who are at risk for type 2 diabetes and they gave them hookworms.

[Latif Nasser]

How do they give it to them? How do they take them? Do you, like, slurp it down like a little piece of spaghetti?

[Molly Webster]

No.

[Dr. Paul Giacoman]

You know, people think where they're going to enroll, they're going to have to swallow a worm or swallow worm eggs, et cetera.

[Molly Webster]

So it's actually much worse.

[Jad Abumrad]

I don't know.

[Molly Webster]

It could be much better than that.

[Dr. Paul Giacoman]

Basically, in order to do our research,

[Molly Webster]

the first step of the process is they have folks who work in their lab, these.

[Dr. Paul Giacoman]

What called worm farms, volunteers who've consented to have a small number of worms

[Molly Webster]

living inside of them.

[Latif Nasser]

Oh, wow.

[Dr. Paul Giacoman]

Yes, exactly. The only way, you can't culture them, you can't just get them and freeze them.

[Molly Webster]

Really?

[Dr. Paul Giacoman]

Yeah. So basically, that's one of the limitations about working with these worms. You actually have to maintain. We call them worm farms.

[Latif Nasser]

So, like, hazard pay for that? Like, do they get a bonus?

[Molly Webster]

No, I think they're just very generous

[Dr. Paul Giacoman]

volunteers, brave and dedicated volunteers. And so that if we want to do our research, we say, hey, generous

[Molly Webster]

volunteer, can you give me a sample of your stool?

[Latif Nasser]

Okay.

[Molly Webster]

Because what happens in these people in the worm farms is the hookworms inside

[Dr. Paul Giacoman]

of them will mate and they can produce. The females can produce tens of thousands of eggs every day, which are released eventually in the poo.

[Latif Nasser]

Huh.

[Molly Webster]

And so they poop.

[Dr. Paul Giacoman]

We get the poo sample, add charcoal to it, which reduces the smell, and then we spread it onto the petri dish.

[Molly Webster]

They leave the petri dish in sort of like kind of a humid tropical environment.

[Latif Nasser]

Okay.

[Molly Webster]

It sits there for a week, and

[Dr. Paul Giacoman]

over the course of that, these tiny

[Molly Webster]

hookworm eggs start to hatch. And emerging from them are these microscopic,

[Dr. Paul Giacoman]

teeny, tiny baby worms, barely visible to the naked eye.

[Molly Webster]

And very quickly, Paul and his team

[Dr. Paul Giacoman]

hit them with, like, a Strong disinfectant to clean them. Then we can basically look down the microscope. We just, one by one, pick the wriggly worms, put them into a little

[Molly Webster]

tube, and then what they do is they put the worms on a band aid, essentially, and they take that band A and they put it on the skin of the patients that are enrolled in the clinical trial.

[David Pritchard]

Oh.

[Latif Nasser]

But not even on a cut. Just anywhere on the skin.

[Molly Webster]

Just anywhere on the skin.

[Dr. Paul Giacoman]

And then we sort of sit with them for about five minutes because participants start to get this tingling sensation, because

[Molly Webster]

what happens is these baby worms on the band aid start to release an enzyme which degrade tissue, which basically melts your skin so that they can start to burrow into your skin. And as they enter your skin, then your skin just closes up behind them. The tunnel closes, and then the worm makes their way down through your skin into the lymphatics, your lymphatic system. So if you think of the inside of your body as a water park, as one does, the lymphatic system is like the laser.

[Latif Nasser]

Sure, yeah, yeah.

[Molly Webster]

So these baby hookworms go through the skin cells, fall into this, like, little lymphatic river, then they float along through your lymph system. I kind of maybe picture them with, I don't know, cozies of non alcoholic beer, because they are babies on their little tube.

[Latif Nasser]

That's funny.

[Molly Webster]

And they're floating downstream. They float along and they get to what is known as your lymphatic duct, which is kind of right by your collarbone. And once they get there, they get shot out of the lymph stream into your bloodstream.

[Dr. Paul Giacoman]

And once they've gone into the blood, they're cruising around like on a water slide.

[Molly Webster]

They go from your collarbone towards the center of your chest, where they catch this huge slide that sends them into your heart. And then your heart, thud, thud, thud, shoots them out onto another big slide. That slide starts splitting and branching and splitting and branching. And as it does, the slide is getting smaller and smaller and smaller until, yeah, these little baby worms get stuck. They get trapped inside a super tiny

[Latif Nasser]

blood vessel because they're too big.

[Molly Webster]

Yeah, they're too big for the blood vessel. So they get stuck there.

[Dr. Paul Giacoman]

Their journey ends.

[Molly Webster]

But Paul says that's their cue to again release an enzyme that starts to melt away the walls of the blood vessel.

[Latif Nasser]

Whoa.

[Molly Webster]

Just enough, they can wriggle their way through and then pop out on the other side of this blood vessel and into your lungs.

[Dr. Paul Giacoman]

And then what they do is they crawl. They crawl up through the lung, all the airways.

[Molly Webster]

Like a rock climber. Boop, boop, boop, boop, boop, boop, boop. Up your trachea so they're almost in your throat.

[Dr. Paul Giacoman]

And then unknowingly, one day you will

[Molly Webster]

cough, which will dislodge these worms from your trachea up into this little free space in your throat where I like to think that they will do a backwards somersault. And then after you cough, you usually swallow.

[Dr. Paul Giacoman]

So, yeah, you'll swallow them.

[Molly Webster]

You swallow the worms.

[Latif Nasser]

Oh, my God.

[Molly Webster]

At which point they will shoot down your esophagus into your stomach.

[Latif Nasser]

Oh, my God.

[Molly Webster]

And then once you.

[Latif Nasser]

Why wouldn't you. Oh, but it's like, why wouldn't you just feed it to people then? Like, why do this whole crazy.

[Molly Webster]

Well, because this whole process from skin to gut takes about two to three weeks. And during that process, the worm is maturing.

[Latif Nasser]

Got it.

[Molly Webster]

And so it's actually developing in such a way that it can survive in your stomach.

[Latif Nasser]

I see. So it's like this is how it develops.

[Molly Webster]

Exactly.

[Dr. Paul Giacoman]

So it's a really fascinating life cycle. They can survive the stomach acid and then they sort of make their home in the upper. Just beyond the stomach there, in their upper small intestine.

[Molly Webster]

And once they're in the small intestine,

[Dr. Paul Giacoman]

they've got these sort of quite violent looking teeth.

[Molly Webster]

They will bite and clamp onto you

[Dr. Paul Giacoman]

and they very fairly delicately just sort of suck the blood.

[Molly Webster]

And this is where something sort of amazing happens, which is for the next two weeks, your body's gonna have this really intense reaction. So where the worm is biting down on your intestinal wall, it's gonna get inflamed. There's like an open sore where the worm is sucking and your body is going to freak out and try and flush the hookworm out. So you're gonna have diarrhea, you're gonna feel sick, and then it's all gonna stop. You're gonna feel fine. And Paul says this is most likely because right around this time, the hookworm has reached full adulthood.

[Dr. Paul Giacoman]

And we've actually, in some of our clinical trials, have taken a camera and we've had a look in the gut at regions of the gut where the worm's been feeding. And, you know, there might be one little small red spot there where next to a worm, but everywhere else, I think there's this rapid healing. The worm might actually be releasing factors that promote, you know, wound healing, for example.

[Molly Webster]

Really?

[Dr. Paul Giacoman]

Yeah, absolutely. It's in their best interest to basically feed and heal. The wounds in their environment.

[Molly Webster]

So the really cool thing is, is that when this hookworm reaches adulthood and it's bit onto you and it's making this hole in your intestine, it can actually release a protein or maybe many proteins to heal the wound at the same time. So you're not left with this gaping wound in your stomach. And then it's also producing other proteins that are quieting the immune system.

[Dr. Paul Giacoman]

Because your immune system could, it could just unleash an enormous attack on these worms. But that would die.

[Molly Webster]

But obviously the worm does not want that. And so it has these little proteins that secrete that tells your immune system, shh, be quiet. And you heard about this in our last episode. And I think this is what Jasper also sort of suspected was happening. There was something overall from the hookworms quieting the immune system.

[Latif Nasser]

I feel like you've kind of reframed this whole thing for me. So now it's become less like a story of a human clinical trial and more of story of like Mission Impossible. On the, on a worm scale, like, I'm like, how can this thing like vault over this but then say the right words to this person that they'll leave them alone and then, and then climb up the da, da, da. And then it's like, it's crazy. And then use their little blaster to like melt this thing so they can walk through this wall. It's like crazy. It's like a crazy thing that they're doing.

[Molly Webster]

But here's the thing, Latif. When Paul and his team got to the end of this two year trial with people who were at risk for type 2 diabetes, the people who were

[Dr. Paul Giacoman]

treated with the hookworms had things like reduced blood glucose levels and they had dramatically reduced insulin resistance levels. Lost a little bit of weight.

[Molly Webster]

And some of these people who were considered pre diabetic were no longer pre diabetic.

[Latif Nasser]

Oh, wow. So some people were cured?

[Molly Webster]

Effectively, yeah, basically.

[Dr. Paul Giacoman]

Well, when you look at the placebo people who got no worms, they went

[Molly Webster]

on to continue having high insulin resistance, glucose, no weight loss.

[Dr. Paul Giacoman]

So it was really the first causal clinical evidence that the worms were having a benefit on metabolic health.

[Molly Webster]

Then at the end of the trial, the end of the two years, the people who had the hookworms inside of them, they have the option to just get rid of the worms. Like you can take an over the counter deworming medication and they'll be gone the next day. Paul says at the end of this two year study, almost everyone kept their worms.

[Latif Nasser]

Wow.

[Dr. Paul Giacoman]

They Were happy at the end. They wanted to basically live with their worms. They were happy with them. And this is universal. Every clinical trial, almost universally at the end of a clinical trial, people are happy with their worms.

[Molly Webster]

Do you think the happiness is emotional or do you think the happiness is like they actually feel different?

[Dr. Paul Giacoman]

Yeah, exactly. So there's two things. One of them, they might think, well, it's not doing them any harm, so let's just keep them. And the other thing is we've, you know, in our two most recent clinical trials, which were placebo controlled.

[Molly Webster]

So these trials were looking at Celiac's disease.

[Latif Nasser]

Yeah.

[Dr. Paul Giacoman]

We asked people to do a quality of life and mood and wellbeing survey. And in both clinical trials, we had this really interesting improvement in well being and mood and sleeping quality.

[Molly Webster]

Wait, really?

[Dr. Paul Giacoman]

That we saw in the people with the, with the worm treatment and the placebos. We didn't see it. I can't explain it. But, you know, the data was there and it's really compelling.

[Molly Webster]

And there is like, what a weird thing.

[Unknown Rockefeller Commission Member]

Right?

[Molly Webster]

I know. So one. Well, here's the thing. I'm going to break that down for you, which is like one of the things we're all talking about right now is our microbiome.

[Jasper Lawrence]

Right?

[Molly Webster]

Right. It's like, what is the tiny stuff living inside of us, like viruses and bacteria that's actually helping us?

[Latif Nasser]

Right.

[Molly Webster]

One of the things Paul's talking about is like, well, there's also a macrobiome.

[Dr. Paul Giacoman]

You know, the macrobiome organisms that you can see with your naked eye these worms that can, you know, somehow live for up to a decade or even longer within our gut. The immune system should really have recognized these worms and kicked them out because they're such a big insult on the body.

[Molly Webster]

But Paul says it could be that when these worms, when they reach adulthood in your gut, when they start making the proteins that quiet your immune system, that actually suppresses the immune system so the immune system doesn't kill it.

[Latif Nasser]

Yeah.

[Molly Webster]

And that also means that then the immune system is like, not reacting as strongly to some other things. So this is where the whole autoimmune thing gets into play. Because in autoimmune diseases, as you know, your own immune system is attacking you.

[Latif Nasser]

Right.

[Molly Webster]

And if you've got a worm inside of you telling the immune system like, hey, you can chill out. I'm kind of part of you, like, don't attack me.

[Latif Nasser]

Yeah, yeah, yeah. Yes.

[Molly Webster]

Then overall, it's just the immune system's not gonna attack you.

[Latif Nasser]

I just, you know, the thing that's really confusing to me is why we've

[Molly Webster]

left you more confused.

[Latif Nasser]

No, because like, why would, like, this is something that we need seemingly to regulate our own kind of internal army. Right. Like, it's like, why would we outsource this very crucial part of ourselves?

[Molly Webster]

Like, like, what do you mean outsource?

[Latif Nasser]

Like, outsource like the worms are not us. Like, like if they're, if they're helping

[Molly Webster]

regulate, we would, we would outsource it because they, because they're helping. Like, we would outsource it because it's beneficial. Like, you have to imagine, like we've been living with worms for millions of years.

[Latif Nasser]

Yeah.

[Molly Webster]

And so a worm got inside of us and we probably killed it. And then a worm got inside of us and it probably killed us. And then a worm got inside of us and it lasted a little longer and then we did or did not die. And it's like basically this long term dance between us and the worm.

[Dr. Paul Giacoman]

So there's this really interesting truce that's happened throughout evolution where the worm benefits and the host benefits.

[Molly Webster]

The worm benefits because it's getting a place to live and some juicy blood to eat for years. And then the host us benefits by not getting sick and dying.

[Dr. Paul Giacoman]

But also it's from the potential immune shaping and metabolic shaping powers of the worm.

[Molly Webster]

So Paul's lab has shown that people who are given hookworms have fewer symptoms associated with type 2 diabetes, celiac's disease. There's also other studies looking for benefits for people with multiple sclerosis, ulcerative colitis. That's where you get ulcers in your intestines, Crohn's disease, Latif. And in those studies, some people have gone into remission with worms. That's not Paul's lab, but that's other labs.

[Latif Nasser]

Yeah.

[Dr. Paul Giacoman]

And you know, if they're beneficial and you know, why not turn it into a treatment?

[Molly Webster]

But that's kind of the thing, which is that since 2009 when we did that Jasper story, even though there are all these studies showing that hookworms are beneficial, hookworms are still not used as a medication or as a treatment.

[Dr. Paul Giacoman]

Yes. There's a lot of hurdles for developing hookworms as a medicinal treatment.

[Molly Webster]

Everyone is kind of like, listen, there's so many reasons why people don't want worms. Like, they're kind of just gross.

[Dr. Paul Giacoman]

But also, I briefly mentioned before, you get the larvae out of people's poo. So making a medicinal product with standardization

[Molly Webster]

and decontamination, it's just really Hard.

[Dr. Paul Giacoman]

Exactly. So at this stage, it's probably never going to be a mainstream treatment.

[Molly Webster]

In fact, Jasper, who we had mentioned was selling worms. He and his wife actually fled the US because they were being investigated by the fda.

[Latif Nasser]

Wow.

[Molly Webster]

And so as an answer to this kind of problem of the live worm, what we're seeing is people like Paul, his team, other researchers, they're trying to develop the proteins hookworms produce to heal your gut or quiet your immune system. They're trying to take those proteins, make them in a lab, and then put them in a pill form. But no one knows what the timetable for that is. And so for now, you really are just stuck with having to get a hookworm.

[Dr. Paul Giacoman]

And there are some sort of more black market where people are actually selling them and you can buy them. But I wouldn't necessarily recommend that for people, partially for the reason, because you're paying money for something which hasn't really been rigorously tested and it hasn't gone through the regulatory processes that other medications need to go through.

[Molly Webster]

And so, yeah, that's where. That's where it's at.

[Latif Nasser]

Okay, but. Okay, I gotta go. But my last question is, Molly, should I get a worm?

[Molly Webster]

I mean, dude, if I was you and I was in pain, I would try and figure out how to get a worm or get into a clinical trial. Can you fly to Australia and get into one of Paul's?

[Latif Nasser]

I think that.

[Molly Webster]

I'll tell you the areas that they're doing it in. The big research areas are like the Netherlands, Australia, New Zealand. You got any trips there planned soon?

[Latif Nasser]

No, you know, just those lucky people over there that get worms, you know?

[Molly Webster]

Well, you know, you could always do what Jasper did, which is just go walk around in some poop and pick up, you know, hookworms plus roundworms plus tapeworms. You know, that's an option.

[Latif Nasser]

No, that's not. I'm not gonna. I'm not gonna roll in a human feces.

[Molly Webster]

That was a. That's a level of desperate you're not at.

[Latif Nasser]

That's not how desperate I am.

[Molly Webster]

Okay, well, Australia it is then. Okay, hitting stop.

[Latif Nasser]

Okay.

[Molly Webster]

Okay, hitting stop.

[Latif Nasser]

Okay. Thank you, Molly Webster for the update.

[Molly Webster]

You're welcome.

[Latif Nasser]

The update was produced by Matt Kilty with help from Rebecca Rand. It was edited by Arianne Wack and fact checked by Diane Kelly.

[Molly Webster]

And we want to thank Pat Walters, Jad Abumrad, Robert Kulwich, and the whole 2009 parasite team that put that episode together. If you want to listen to the entire parasite episode, you can go check it out on our website.

[Latif Nasser]

And for everything else, Radio Labby. Please subscribe to our totally FDA approved newsletter. All right, we'll be right back.

[Molly Webster]

In 20 years.

[Latif Nasser]

In 20 years.

[Molly Webster]

No, just next week.

[Latif Nasser]

Yeah, we'll catch you next week.

[Molly Webster]

Bye.

[Gabby Santis]

Hi, I'm Gabby. I'm from the Bay Area, California. And here are the staff credits. Radiolab is hosted by Lulu Miller and Latif Nasser. Soren Wheeler is our executive editor. Sarah Sandbach is our executive director. Our managing editor is Pat Walters. Dylan Keefe is our director of sound design. Our staff includes Jeremy Bloom, W. Harry Fortuna, David Gable, Maria Paz Gutierrez, Sindhu Nainasambandan, Matt Kielty, Mona Margauker, Alex Neeson, Sara Khari, Natalia Ramirez, Rebecca Rand, Anissa Vitce, Arian Wack, Molly Webster and Jessica Young, with help from Gabby Santis. Our fact checkers are Diane Kelly, Emily Krieger, Natalie Middleton, Angeli Mercado and Sophie Semay.

[Latif Nasser]

Hey, Radiolab. Michael, Tacoma, Washington Leadership support for Radiolab Science programming is provided by the Simons

[Molly Webster]

foundation and the John Templeton Foundation.

[Latif Nasser]

Foundational support for Radiolabs was provided by the Alfred P. Sloan Foundation.