Intestinal parasites are often overlooked as a potential cause of disease in the digestive system and in many other seemingly unrelated health concerns. There is increasing evidence of the ability to cause illness by relatively common parasitic organisms previously considered to be commensal organisms (i.e. living together in balance with other organisms in a given environment). Thus parasite treatment options become important ‘getting healthy’ health strategies to consider.
In such cases it is important to investigate and remove the parasites, where they are found in people presenting with significant gastrointestinal complaints (cramping, bloating, diarrhoea, constipation, pain etc) combined with fatigue, low energy, brain fog and memory lapses, anxiety, depression or headaches, to name a few.
Dientamoeba fragilis (D.fragilis) and Blastocystis hominis (Blastocystis) are two common microscopic parasites found throughout the world that can negatively impact many aspects of health in both children and adults. These two parasites are quite common in Australia in both children and adults.
In this post I’d like to share my experience in providing natural parasite treatments in the Sydney clinic as well as online (via Skype/ Zoom), plus provide you with an overview of the current research in this area, and discuss natural treatment options.
Causes of parasitic infections
Blastocystis and D.fragilis are both a protozoal-type microbes that can infect the human digestive tract. Causes of parasite infections are many but most include altered internal environment (e.g. excess of internal and/ or external toxins, poor digestion and elimination, and impaired detox system), low immune system, depleted adrenals causing low energy and tiredness, too much stress, damaged gut wall, poor diet and microbiome imbalances.
The microbiome comprises all of the genetic material of all the microbes within the human gut.
Often parasites are acquired during overseas travel when eating poorly prepared food and drinking unboiled local water. Many are infected by having either direct or indirect contact with people who are carriers e.g. people who have parasites and work in restaurants and take-away food outlets. Importantly, many of those infected are asymptomatic carriers and don’t know they are infected (1).
The parasites spread through the faecal-oral route particularly under poor hygiene conditions, contaminated foods and drinking unboiled dirty water. Once a person has been infected, the parasites live in the large intestine and are passed in faeces. The parasites are protected by an outer shell, therefore they can survive outside the body and in the environment for long periods – months and even years (2).
Symptoms of parasitic infections
Symptoms severity depends on the parasite genotype (there are multiple species of Blastocystis, up to 15 have been identified so far, some of them may not be harmful though), person’s own genetic makeup, levels of immunity and age, to name a few. Stool culture (minimum of three days stool samples or a one day PCR stool test) currently provides the most sensitive diagnostic method for evaluating the presence and levels of Blastocystis and D.fragilis.
However, the tests are not 100% reliable and some tests can produce false negative results due to the varying methodologies, the PCR test (that looks for DNA of different microbes) is being considered as the most reliable at present. It’s not uncommon for both parasites to be present in the large intestine at the same time producing more severe symptoms and increasing the complexity of treatments (3).
The bad news is there is not one typical symptom associated with these parasitic infections to help with identification and diagnosis. The two parasites are associated with a range of similar non-specific gastrointestinal symptoms including diarrhoea and/ or constipation, abdominal discomfort and cramping, reflux (heartburn), severe bloating, flatulence and cramping pain.
Other symptoms may include nausea, vomiting, headaches, dizziness, weight-loss, chronic fatigue, depression, low-grade fever, bloody stools and anal itching. Some case reports have also suggested that inflammatory bowel disease (IBD) such as colitis and Crohn’s disease, and irritable bowel syndrome (IBS) are associated with Blastocystis and/ or D. Fragilis infection. Interestingly, IBS is the only functional bowel disorder where a protozoal infection has been found in almost half of diagnosed cases (2).
Intestinal permeability or leaky gut also increases in patients with Blastocystis and D.fragilis and other parasites such as Giardia, because they actually damage the gut wall with the toxins they produce. The parasites also adhere to the gut walls creating structures called biofilms ‘aka’ bunkers where they live and hide from the immune system.
This finding supports the view that leaky gut increases during the course of pathogenic protozoan infections, causing damage to the intestinal wall, while other non-pathogenic protozoan infections have no effect on it. The increase in leaky gut in patients with Blastocystis supports the view that it can be considered a pathogenic protozoan (3).
Having stated the above symptoms and negative aspects of parasitic infections, it’s important to note that it is not yet definitely proven that Blastocystis is a pathogenic parasite in all cases. A more accurate term proposed recently by the Blastocystis expert Professor Rune Stensvold, is that Blastocystis is a ‘symbiont’, so in many people it could well be just be an incidental organism (an organism that normally lives on a host other than its normal host).
Some researchers are even proposing it could be commensal and be playing a beneficial role in some way. More research will bring answers in time but in the meantime, each person needs to be evaluated based on the facts (test results) and their symptoms.
Testing for parasites
At present the most reliable and acurate test for intestinal parasites is a stool test called Faecal MCS and PCR test (MSC stands for Microscopy, Culture and Sensitivity; PCR stands for Polymerase Chain Reaction which tests for DNA fragments of parasites). Your GP can refer you for this test which is covered by Medicare in Australia. The test detects 10 most common parasites and bacteria:
- Parasites: Dientamoeba sp, Blastocystis sp, Cryptosporidium sp, Giardia sp, Entamoeba histolytica
- Bacteria: Salmonella sp, Campylobacter sp, Shigella sp, Yersinia enterocolitica, Aeromonas sp,
Other tests I commonly refer my clients for are performed by functional labs I work with and include:
- GI Effects by Genova Diagnostics lab – this is currently the most reliable and comprehensive test that also covers detailed gut microbiome analysis, digestive function and gut inflammation markers. It provides invaluable information for tailoring treatment protocols for each client, the management of gut health and overall health as well. The test is done at home (one stool sample is needed) and then posted for analysis to the US.
- Complete Digestive Stool Assessment (CDSA) where a stool sample is collected every day for 3 days to gauge the digestive function and microbiome bacterial balance. This test is done at home and the specimen are couriered to the lab for analysis. DNA Multiplex PCR test can be added to any CDSA test if parasites are suspected.
Overall, there are two groups of people with confirmed parasitic infections (via the most reliable PCR test):
- Individuals with no apparent symptoms, gut or other symptoms as described above, who are otherwise healthy and well (as reported by them and supported by ‘normal’ blood test results).
- Others who suffer from moderate to severe symptoms that significantly interfere with their health and wellbeing, often leading to long-term poor physical and emotional outcomes and decreased quality of life. These are the people who need to consider embarking on parasite treatment such as one described below.
Many people may suffer for years or decades with severe IBS-like symptoms that can’t be explained before a proper diagnosis is made. In fact, they are often misdiagnosed as having ‘IBS’, sadly without a hope of improving if the parasites are present but not investigated and removed or decreased in numbers.
Doctors most often treat parasitic infections with a combination of strong antibiotics, after which some patients (but not all) report either resolution or a significant reduction in symptoms.
However, such parasite treatment methods often fail further down the track, even after repeat treatments with strong antibiotics, as the parasites become resistant to the drugs and the gut and immune systems get damaged, and subsequently not able to protect against re-infection. Many patients may even get worse because of the gut damage done by the antibiotics and the weakened immune system.
My current understanding is that there is no one reliable parasite treatment /therapy to eradicate Blastocystis and/ or D.fragilis. However, there are naturopathic parasite treatments, including remedies utilising specific antimicrobial and antiparasitic herbs, that are helpful in killing off parasites over a longer period of time (3-6+ months).
It’s a much gentler, albeit longer, method than repeated courses of antibiotics which, as mentioned above, often don’t work, as parasite become resistant to them. In addition, gut damage and microbial imbalances from taking antibiotics can be challenging to repair long-term. Importantly, Blastocystis can also stop responding to antiparasitic herbs as it can adapt if the same herb(s) are prescribed for a longer period of time.
Fortunately, by using multiple herbs with many different natural constituents makes it much harder for the parasites to become resistant to treatment, as they act synergically. Also, the herbs and supplements support gut lining, the liver, digestion and absorption of nutrients, thus supporting and speeding up the healing process at the same time.
One effective natural parasite treatment strategy is to employ a periodic rotation of specific antimicrobial herbs throughout the treatment. This method will give the immune system an advantage over the parasite’s abilities to adapt, thus increasing the likelihood of eradication over time.
Homeopathic remedies are also helpful when used in conjunction with herbs and dietary therapy to further progress the removal. Other synergistic nutritional supplements and foods are also key in making the parasites wanting to permanently move out. These include: garlic, ginger, black pepper (5), herbs like wormwood, black walnut, turmeric, Pau D’Arco; pomegranate husk, citrus seed extract; oregano oil; prebiotics and probiotics, especially Saccharomyces boulardi.
Unfortunately, many people find that after trying to eradicate Blastocystis for months or years, they still test positive for it. As mentioned above, the parasite becomes resistant to drugs or natural treatments and therefore they may never be fully eliminated in some people, even after years of treatment.
On a brighter note, even though the parasites are still detected on testing, many people feel much better and their symptoms subside considerably, whilst they adhere to specific nutrition, supplements and lifestyle choices which support the immune system and the gut.
It’s known that taking multiple rounds of antibiotics has many negative effects on the gut and the immune system function. Therefore it is prudent to investigate other possibilities for the symptoms first. For example, many people (working with gut health knowledgeable practitioners) who just focus on healing the gut and improving microbiome health by using prebiotics, probiotics, dietary adjustments, etc, will significantly improve or even solve their symptoms all together.
As mentioned above, before commencing any parasite treatment, it’s very useful to perform a comprehensive digestive stool analysis (CDSA) that uses PCR technology (which looks for DNA of different microbes). This test also measures the levels of dysbiosis (imbalances of gut flora), pancreatic function, nutrient malabsorption, and other digestive markers.
IMPORTANT CONSIDERATIONS: After performing the tests, many people find that having Blastocystis is not their main problem or the cause of their symptoms. Instead their source of ill health could be SIBO (small intestine bacterial overgrowth), giardia (another common parasite), dysbiosis, candida, hernia, or just high stress.
By treating those other identified imbalances first, many people start to feel much better and their symptoms decrease significantly, thereby avoiding having antibiotics that may be unnecessary. They may still have Blastocystis, according to the tests, but they feel well and have no symptoms.
Natural parasite treatment considerations
From my experience as well as via feedback from other natural health practitioners working in this area, treatments, both natural and conventional, are often long and complex, and cover a number of aspects as determined by patient’s severity and duration of symptoms, his/ her current state of health, stress levels and their nutritional status.
It’s essential to stage and plan the parasite treatment over time and not panic and attack the parasites straight away with ‘heavy weapons’ such as multiple antibiotics, strong antimicrobial herbs and other harsh purges. These aggressive strategies will not work in most cases as the parasites defend themselves cleverly whilst the gut and immune system are depleted by the treatment.
To make major inroads, you’ll require patience, perseverance and education on how the body works to naturally expel the parasites, combined with the help provided by specific remedies and herbs. Understandably, most clients want the parasites out as soon as possible regardless of their immune system strength and their bodies’ readiness for the likely long and often tricky fight.
More often than not there is also a significant stress component to deal with as clients find that having been diagnosed with parasites is unnerving, uncomfortable and physically and mentally draining.
My parasite treatment protocol is personalised for each person and it typically includes the following stages:
- Preparatory phase (duration: 4-8 weeks) – boosting the immune system, the adrenal glands, decreasing stress, gut and liver support plus improving body’s detox capacities as well as removing some toxins prior to the parasite eradication step.
- Parasite purge (duration: 3-4 months or more as per client’s needs) – antiparasitic treatment using specific herbs, supplements and foods.
- Removal of toxins and debris / gut repair/ digestive support / improving sIga secretion (ongoing: before, during and after the protocol). Main medicines utilised are: herbs, supplements, specific foods, lifestyle modifications.
- Liver and detox support (duration: ongoing – before, during and after the protocol). Main remedies utilised are: herbs, supplements and specific foods.
- Stress release/ reduction activities (duration: ongoing – before, during and after the protocol) – tailored stress release techniques to support the immune system, adrenals and the whole body and mind to cope with the long-term treatment.
- Anti-parasitic diet and nutrition (duration: ongoing – before, during and after the protocol) – this is the key part of treatment and the foundation of good gut health involving leaky gut repairs, beneficial bacteria levels and building immune system resilience to minimise possible re-infestation in the future. Adherence to the dietary guidelines is vital and plays an important part of the treatment; however, nutrition alone is not likely to eradicate the parasites.
- Over time I developed specific nutrition guidelines for all clients undergoing natural parasite treatments, using certain foods, herbs and herbal teas as effective anti-parasitic medicines, in addition to the key antimicrobial and anti-parasitic herbs and supplements. Included is a summary of my recommendations, you can download it and start implementing the guidelines today. Download the Key Nutrition Guidelines for Parasitic Infections here.
This natural parasite cleanse works quite well for people who have had the parasitic infection for shorter periods of time (for months and up to 12 months).
For clients with long-standing infections (sometimes lasting for 5-10+ years), a combination of antibiotics and natural medicines may be necessary, providing they go through the preparatory and gut repair treatment phases prior to taking antibiotics, and are well/ strong enough to tolerate high doses of antibiotics.
These individuals also need to follow the remaining steps of my natural parasite cleanse after taking antibiotics, as stated above, to restore gut integrity and the immune system function. Naturally, each client needs to be assessed on an individual basis and treatment tailored to their needs.
If you live in Australia consider contacting me for assistance with parasite infection treatments for Blastocystis, D.fragilis or other parasites. Over the time working in this area I developed my own treatment protocols based on the clinical experience, exchange of ideas with and feedback from other practitioners and extensive, ongoing research I conduct on this topic to keep up to date.
To better serve my clients I developed the Natural Parasite Cleanse Program to provide personalised, comprehensive and methodical treatments to eradicate parasites and improve the gut health and function in general. Find out more about this unique program here.
For convenience and easier access to natural parasite treatments, I offer Skype consultations Australia-wide and also see clients in the Sydney CBD clinic. I’m afraid I’m not able to offer any specific treatments or advice to individuals based elsewhere.
Parasitic infections of the intestines are emerging as significant components of many digestive and other inflammatory conditions, and need to be taken into account during initial assessment, when indicated. Particularly, if you suffer from multiple, non-specific gut symptoms such as IBS and other non-specific symptoms such as anxiety, unexplained sleep disturbances; mood disorders or brain fog; aches and pains etx, and have not been investigated for the presence of parasites.
Please consider this option as part of your health assessment. It may well be the missing piece in the puzzle!
In conclusion, a long-term success with eradicating or significantly decreasing parasite levels depends on your overall gut health, well-functioning immune system and effective stress management, including good sleep and rest.
Unless you change your internal environment (terrain), re-activate your immune system to detect and kill the clever, ever changing and hiding pathogens, and make the internal environment more hostile (i.e. more healthy) for opportunistic parasites, viruses and bacteria, there is little chance to permanently improve or succeed long-term.
Special announcement: Improving sleep and effective stress management are major components of any parasite treatment. I recently published a detailed guide on how to deal with insomnia and sleep difficulties using natural medicines, nutrition and lifestyle adjustments. The advice and tips included are based on my clinical experience in addressing sleep problems as well as extensive research into natural sleep solutions.
Good health and blessings
Adrenal Fatigue and Digestive Health Expert
Naturopath || Herbalist || Nutritionist || Reiki Practitioner
1) Oh my aching gut: irritable bowel syndrome, Blastocystis, and asymptomatic infection. Boorom KF, Smith H, Nimri L, Viscogliosi E, Spanakos G, Parkar U, Li LH, Zhou XN, Ok UZ, Leelayoova S, Jones MS. Parasit Vectors. 2008 Oct 21; http://www.parasitesandvectors.com/content/1/1/40
2) Blastocystosis in patients with gastrointestinal symptoms: a case–control study. Ayhan Hilmi Cekin, Yesim Cekin, Yesim Adakan, Ezel Tasdemir, Fatma Gulsun Koclar and Basak Oguz Yolcular, Department of Parasitology, Antalya Training and Research Hospital, Istanbul, Turkey
BMC Gastroenterology 2012 12:122 DOI: 10.1186/1471-230X-12-122. http://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-12-122
3) Blastocystis Research Foundation. http://bhomcenter.org/wp/
4) Cytokine changes in colonic mucosa associated with Blastocystis spp. subtypes 1 and 3 in diarrhoea-predominant irritable bowel syndrome. Yakoob J, Abbas Z, Usman MW, Sultana A, Islam M, Awan S, Ahmad Z, Hamid S, Jafri W. Parasitology. 2014 Jun;141(7) http://www.ncbi.nlm.nih.gov/pubmed/24598032
5) In vitro sensitivity of Blastocystis hominis to garlic, ginger, white cumin, and black pepper used in diet. Yakoob J, Abbas Z, Beg MA, Naz S, Awan S, Hamid S, Jafri W. Parasitol Res. 2011 Aug;109(2):379-85. http://www.ncbi.nlm.nih.gov/pubmed/21431384
6) Blastocystis hominis and Dientamoeba fragilis in patients fulfilling irritable bowel syndrome criteria. Yakoob J, Jafri W, Beg MA, Abbas Z, Naz S, Islam M, Khan R. Parasitol Res. 2010 Aug; http://www.ncbi.nlm.nih.gov/pubmed/24598032