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\n Illustration: Olivier Heiligers\n <\/p>\n
How many photos of human excrement<\/a> have you seen on social media this week? One, two, a few, several? If you\u2019ve taught your algorithm that you\u2019re open to alternative wellness solutions<\/a>, the answer is likely more than zero. Perhaps you\u2019ve been made to bear witness to long, gnarly, brown ropes<\/a> laid out on paper towels. Maybe you\u2019ve seen a pile of what looks like spaghetti squash<\/a> floating in a toilet. You may have been treated to pics of shriveled, dried-apricot\u2013like bits<\/a> harvested from a stranger\u2019s feces. Given the many poop posts, you\u2019d be forgiven for believing that the entire internet-using population is teeming with intestinal worms, which these posters say they\u2019ve expelled with \u201cparasite cleanses\u201d before snapping a pic and slapping up a Reel or TikTok to prove it.<\/p>\n Over the summer, supermodel Heidi Klum<\/a> unwittingly stoked parasite panic by telling<\/a> The Wall Street Journal she was undertaking her first cleanse. \u201cEverything I\u2019m getting on my Instagram feed at the moment is about worms and parasites,\u201d Klum said in the interview. \u201cI heard that you\u2019re supposed to do this once a year, and I\u2019ve never done it. So I feel like I\u2019m really behind. I don\u2019t know what the heck is going to come out.\u201d By November, Klum had cleansed, but the results were unclear. \u201cSo many people asked me, too, like, \u2018What happened?\u2019\u201d she told People<\/a>. \u201cI\u2019m like, \u2018I don\u2019t even know if anything happened!\u2019\u201d There had been no smoking gun, no writhing toilet of expelled creatures \u2014 but also no statement of regret. In fact, Klum exclaimed that \u201cit just felt good,\u201d since any parasites that might have been there \u201cwere leaving the body.\u201d<\/p>\n Klum had embarked on the endeavor repeating an adage often spouted by those in the cleanse community: Everyone has parasites, and they just don\u2019t know it. A common stat bandied about is 90<\/a> percent of the population. Wild as the figure may sound, the notion has just enough plausibility to pass many folks\u2019 b.s. detectors. Don\u2019t tiny, imperceptible mites live on our eyelashes? Don\u2019t dogs get worms, scooting their butts on the carpet for relief? Is it then so crazy to think that wriggling menaces may have colonized our colons, too? Toss in the ardent proselytizing of online \u201cexperts\u201d and those eye-popping photos, and you can see how someone might be swayed. It also doesn\u2019t hurt that cleanses are made to seem \u201cnatural,\u201d almost spa-like, consisting of earthy stuff like black walnut, wormwood, clove<\/a>, burdock root<\/a>, or garlic<\/a>.<\/p>\n Nearly every medical association and traditional doctor<\/a> unambiguously rejects the everyone-has-worms decrees and sees little value in cleanses: No, they\u2019re happy to assure you, you likely do not have intestinal parasites, and eating ground papaya seeds for a week probably wouldn\u2019t help if you did. But trying to dissuade cleanse believers often only deepens their conviction. Disavowal by the medical community is viewed not as scientific sensemaking but as, at best, dogmatic myopia, and at worst, evidence of a shady allegiance to Big Pharma \u2014 a desire to keep you sick so they can sell you bogus cures. As is true of many facets of American life these days, parasite mania seems to be a disagreement between two realities: one in which the medical Establishment is the utmost health authority (or at least it was until recently), and one in which real care is purveyed by the truth tellers this same Establishment shuns.<\/p>\n It would be simpler if there were zero truth to the rampant parasite concerns. But it\u2019s more complicated than, say, vaccine hesitancy, in which one side is demonstrably correct and the other side refuses to believe it. With intestinal worms, we face a paradoxical truth: They are both less common and more common than we think.<\/p>\n \u201cA lot of the people who feel they are infected with parasites are not,\u201d says Dr. Daniel Griffin, a clinical instructor of medicine and infectious-disease specialist at Columbia and president of Parasites Without Borders<\/a>, an advocacy organization dedicated to addressing global parasitic illness. \u201cBut the other side,\u201d he continues, \u201cis that people out there actually are having issues related to parasites but are not being diagnosed.\u201d The double-edged sword of parasitic infection is that its symptoms \u2014 diarrhea, bloating, nausea, gas \u2014 are common enough that one could attribute them to anything from indigestion to a hangover, but these symptoms are also common enough that, if someone told you everyone has worms and you believed them, those symptoms might be enough to convince you that you have them, too. Ask a roomful of people if they\u2019ve had diarrhea, bloating, nausea, or gas in the last month, and 90 percent are likely to raise their hand.<\/p>\n Parasites Without Borders\u2019 work makes clear that the scope of the problem varies by region. A quarter<\/a> of the global population has some form of intestinal worm, known as a helminth, though that jumps to as high as 50 percent in tropical and subtropical regions. Most<\/a> helminths spread via human feces, especially in places where people defecate outside; when feces contains worm eggs, the soil it touches becomes contaminated, and if that soil is used to grow food, the parasite spreads. Hookworms and strongyloides<\/a>, however, can latch onto a host through the soles of their feet if walked on barefoot; tapeworms and trichinella can enter your body through undercooked meat; and flukes can be caught by ingesting contaminated water or fish. The most common global helminth is Ascaris lumbricoides, a roundworm that affects 1 billion people worldwide. While helminths are generally not deadly, if allowed to proliferate, some can cause bowel obstruction, inflammation, and chronic malnutrition<\/a> in children; if the host is pregnant, some worms can be detrimental<\/a> to the fetus.<\/p>\n In the United States, however, intestinal parasites are less common and less dangerous. \u201cThe classic example,\u201d Griffin says, \u201cis pinworm, which we have a fair amount of in the U.S. and which often goes undiagnosed.\u201d Pinworm does not pose much threat beyond an itchy anus, but it does affect 40 million<\/a> Americans \u2014 mostly kids, who tend to pass it around by failing to wash their hands after scratching said anus. Pinworms live in the digestive tract and can be diagnosed using the \u201ctape test\u201d: After the suspected host falls asleep, pinworms venture out to lay eggs, and a piece of tape is placed on the anus to capture them. Two doses of an anti-parasitic<\/a> and a load of laundry later (to rid bedsheets and clothes of eggs), the host is cured. But treatment requires diagnosis, and hosts don\u2019t always know they have pinworms \u2014 around 40<\/a> percent of cases are asymptomatic. Even if symptoms are present, children<\/a> and adults<\/a> may be too embarrassed to speak up.<\/p>\n Another paradox: While you\u2019d think the panic over ubiquitous parasites would help more people with actual worms get proper care, the trendy nature of the topic may be worsening the problem of underdiagnosis. \u201cA lot of people self-diagnose with parasites, then come to a doctor with a little container of their feces not for us to make a diagnosis, but to confirm their conviction,\u201d Griffin says. \u201cThey can be difficult. They can be hostile. Most doctors, to be honest, will put delusional parasitosis at the top of their differential, and things just go south from there.\u201d In other words, even if you\u2019re right, telling a GP you have worms and refusing to entertain other possibilities might get you written off as just another internet faddist or maybe even someone with a mental-health disorder.<\/p>\n Delusional parasitosis is usually secondary<\/a> to another psychiatric condition, like schizophrenia or bipolar disorder, and while recorded cases are exceedingly rare<\/a>, it\u2019s estimated that many people with the condition go undiagnosed since they don\u2019t visit a mental-health professional to discuss it. Instead, because they are certain they have a parasite, they see a medical doctor. \u201cYou can imagine how challenging that can be for many physicians,\u201d says Paul Greene<\/a>, the director of the Manhattan Center for Cognitive Behavioral Therapy, who has expertise in health anxiety. \u201cThey have to rule out the presence of parasites, but they\u2019re really dealing with a psychiatric condition.\u201d<\/p>\n If a patient is dismissed by medical doctors, where might they turn? To the wide, unregulated, FDA-unapproved world of parasite cleanses, sold on Amazon, on Etsy, and by countless independent cleanse purveyors. While it\u2019s difficult to gauge exactly how many people use them, Amazon reviews give some indication: ParaGuard<\/a> ($29.90), one of the most popular options, had 30,451 reviews at press time. Interestingly, some of these clearly parasite-invoking options don\u2019t actually use the word parasite in their product descriptions, most likely because the FDA prohibits<\/a> supplement manufacturers from making medical claims related to treating disease. Many people, however, opt for cleanses they read about in online testimonials or hear about via word of mouth \u2014 which is precisely how Shannon Nesbitt, of Kauai, found her favorite cleanse, Sanctuary Holistic Wellness<\/a> ($377). \u201cMy friend did it,\u201d says Nesbitt, who is 55, \u201cand she\u2019s vegan, and she had all these worms come out \u2014 so I figured if she has them, I definitely have them.\u201d Nesbitt suffered from constipation and, after her friend\u2019s experience, wondered if parasites might be the cause.<\/p>\n The cleanse took a week and consisted of once- or twice-daily enemas, unlimited fruit and pur\u00e9ed soup (but no other solid foods), various teas and tinctures, green shakes, probiotics, prebiotics, psyllium husk, and bentonite clay dissolved in water. It was recommended that the cleanse be conducted around the time of a full moon. The psyllium husk was to be taken only with Concord grape juice. One day, Nesbitt ingested a mixture of olive oil, ruby-red grapefruit juice, and Epsom salts before lying on one side, per the instructions; this was to purge gallstones, and she says she passed hundreds the following day. Then there were the worms: \u201cI was surprised,\u201d Nesbitt says. \u201cThere were these big, long, white worms, and a lot of liver flukes<\/a>.\u201d<\/p>\n \u201cWere any of them alive?\u201d I ask. \u201cWere they moving?\u201d<\/p>\n \u201cNo,\u201d Nesbitt says. \u201cThey were all dead.\u201d<\/p>\n She\u2019s planning to do the cleanse again in a few months \u2014 because, as cleanse purveyors are quick to mention, parasites always come back. A cleanse isn\u2019t a onetime medical treatment so much as a long-term self-care routine.<\/p>\n In poking around the vast array of cleanse-related Instagram posts, I saw a comment a woman had left about one she liked. I messaged her to talk. She replied, but I was confused when she referred me to her husband, Christian \u2014 until it turned out that he isn\u2019t just a fellow fan of parasite cleanses but actually recommends them as part of his health-coaching business, Healing United<\/a>, which he runs alongside his business partner, a primary-care doctor in Missouri.<\/p>\n \u201cWe\u2019re all growing more toxic by the year,\u201d Christian Elliot says over Zoom. \u201cThere\u2019s a reason why worms find a home inside of us.\u201d Certified as a nutritionist and personal trainer, he first came to parasite cleanses as a patient who wanted to know what he\u2019d found in his poop. \u201cIn about 2013,\u201d he says, \u201cI was on a cruise, and I passed a foot-long worm as thick as a No. 2 pencil. And you kind of go, If that\u2019s in me, maybe it\u2019s not the only one.\u201d Elliot went to a naturopath, where he underwent two stool tests that came back negative for parasites; still, he tried her worm protocol. \u201cI couldn\u2019t make it all the way,\u201d he says. \u201cIt was two weeks of suffering. I was in so much pain from the die-off.\u201d (In the cleanse world, this refers to an extinction burst of toxins released as parasites and bacteria gradually die inside of you.) Another cleanse he tried induced \u201cone hot-fire bowel movement, but no worms came out that I could see.\u201d<\/p>\n I just passed what looked like a bowl full of angel-hair pasta.<\/p>\n \u201cI thought, I\u2019ve got to figure this out,\u201d Elliot says. He turned to the practitioners he\u2019d been working with at Healing United, which, he says, was initially founded as a means of detoxing people injured by COVID vaccines. (Other topics Elliot touched on during our chat: chemtrails, changing the MMR vaccine schedule, and the potential dangers of fluoride.) Ultimately, Elliot and his team landed on a complex program of tinctures, herbs, fiber, \u201cbinders\u201d (a material that attaches to dying parasites\u2019 toxins to help flush them out, like clay), and three weeks of daily enemas. He says the results are startling. \u201cI had a client two weeks ago who told me, \u2018I just passed what looked like a bowl full of angel-hair pasta.\u2019\u201d Elliot says he himself passed \u201ca bowlful\u201d of pinworms (is a bowl the standard unit of worm measurement?), along with many red, marble-size liver flukes.<\/p>\n Healing United recommends numerous parasite-curing enemas; I ask Elliot what they contain. \u201cThings like salt and baking soda are profound,\u201d Elliot says. \u201cGarlic is profound. Turpentine, castor oil, these are wildly effective at poisoning. Tapeworms especially don\u2019t like turpentine; they hate it.\u201d He also mentions the benefits of clay, charcoal, and a half-dozen essential oils.<\/p>\n \u201cWhen you were ill, did you consider going to a doctor for an anti-parasitic?\u201d I ask.<\/p>\n \u201cI have an aversion to the medical system,\u201d Elliot says. While he concedes that emergency services and trauma care are worthwhile uses of traditional medicine, he\u2019s philosophically opposed to its other applications. \u201cIt sounds hyperbolic, but it\u2019s anti-human. It\u2019s symptom, symptom, symptom. \u2018Don\u2019t bother me with why this is happening, I just want to treat your symptom,\u2019 which leads to another symptom and another. The model of pharmaceuticals is chemical intervention, and they\u2019re trying to figure out how much poison they can give you without giving you a side effect or killing you.\u201d<\/p>\n What does he say to parasite-cleanse skeptics? What does he say to people who are worried about filling their colons with clay and garlic and flammable solvents?<\/p>\n \u201cI\u2019ve had to get used to the fact that if somebody goes and searches this,\u201d he says, \u201cthey\u2019re going to be scared \u2014 like, Oh my gosh, the internet says this could hurt me.\u201d<\/p>\n Dr. Katrine Wallace is an epidemiologist at the University of Illinois Chicago who posts about parasite cleanses under the Instagram handle @epidemiologistkat. (A recent example<\/a> was titled \u201cParasite Cleanses are Not a Real Thing,\u201d with the caption, \u201cI cannot believe how y\u2019all want to waste your money with these online grifters.\u201d) When we speak, I tell her about turpentine enemas.<\/p>\n \u201cOh, lovely,\u201d Wallace says witheringly. \u201cAnd so often the people selling these cleanses are laypersons \u2014 like, I already roll my eyes at naturopaths and chiropractors, but this isn\u2019t even that, you know? And if I did that cleanse and got really sick, that person is not going to take any responsibility for me because they\u2019re not a medical professional. They don\u2019t see the end result of what they\u2019re doing.\u201d (The website of Elliot\u2019s company mentions that \u201ca doctor and a coach\u201d are available for \u201cCode Red\u201d calls should any unpleasant symptoms arise \u2014 but nowhere does it recommend simply going to the ER if a Code Red situation should occur.)<\/p>\n But what accounts for all the positive reviews for cleanses \u2014 what exactly are folks seeing when \u201cworms\u201d come out of them by the bowlful?<\/p>\n \u201cMucus,\u201d Wallace says. \u201cUndigested food. Intestinal lining. You ever notice how none of the \u2018worms\u2019 are moving?\u201d Dr. Griffin told me something similar \u2014 that sloughed-off bits of intestine and fibrous vegetables that don\u2019t get fully broken down can look like worms, provided you don\u2019t know what worms look like. None of the photos he\u2019s seen online or unsolicited specimens he\u2019s viewed in person show segments on the worms, which is characteristic of tapeworms, and he\u2019s yet to see any that are moving, the way pinworms would be. The Mayo Clinic also has an answer<\/a> for those hundreds of \u201cgallstones\u201d Nesbitt passed: Because most gallstone cleanses involve olive oil, what cleansers are seeing is just globs of \u201coil, juice, and other materials.\u201d Wallace continues, \u201cNormal people are not passing these things; it\u2019s likely a result of the cleanse \u2014 just not in the way they think. Not to mention that half the time online they don\u2019t show a picture of what came out; they just say it came out.\u201d<\/p>\n But why do they feel better? Why did Shannon Nesbitt\u2019s constipation go away?<\/p>\n Griffin had an answer for this: \u201cPossibly because the cleanse has accidentally corrected a dysbiosis,\u201d he says, referring to an imbalance of microorganisms in the gut. \u201cIn their head, they think, I feel better because I treated my parasite. The reality is they might feel better because they\u2019ve improved their microbiome.\u201d<\/p>\n \u201cWhat gets me,\u201d Wallace says, \u201cis that ivermectin is an anti-parasitic, but they want to use it for everything but parasites. They want to use it for COVID, for cancer. It\u2019s like, this is its time to shine, people.\u201d (Ivermectin\u2019s star turn began during the pandemic, when a rash of skeptics began using the dewormer, which is generally used in livestock, to treat COVID against the advice of doctors.) When Wallace says \u201cthey,\u201d she seems to mean some variation on people who don\u2019t trust science. Without ever mentioning them by name, I get the feeling that we\u2019re talking about adherents to and peddlers within the MAHA movement, who, alongside their own legitimately worm-bedeviled leader, Robert F. Kennedy Jr., believe they\u2019ll Make America Healthy Again.<\/p>\n \u201cThere\u2019s never been studies on these cleanses,\u201d Wallace says. \u201cThere\u2019s no data, absolutely no science behind it, other than the reports we\u2019ve seen of people with liver damage from taking supplements because they don\u2019t know what\u2019s in them. But that really doesn\u2019t matter to these people. They go off personal narrative and appeal to emotion. And that\u2019s effective.\u201d<\/p>\n Maybe all parasite-cleanse purveyors are \u201cgrifters.\u201d But it seems equally likely to me that some are merely gullible; after they saw their \u201cworms\u201d in the toilet, they decided to \u201chelp\u201d others, too. Surely others are fed up with America\u2019s exploitive medical industrial complex and are looking for a way around it.<\/p>\n \u201cI think some of it is distrust of the health-care system,\u201d says Wallace, seeming to intuit my thoughts, \u201cand this idea that doctors just want to make money by peddling pharmaceuticals. But if you see a doctor for an anti-parasitic, yes, the visit might cost money, but you\u2019d take a couple doses of generic medication. Whereas if you go on Instagram and buy months of this regimen, that\u2019s way more money.\u201d Wallace also acknowledges that internet medicine may be the only kind some people can access: \u201cMaybe they don\u2019t have insurance, so these wellness fads are something they do in lieu of going to the doctor. They think they\u2019re really doing something good.\u201d Or maybe there are, as she says, \u201cjust a lot of fringe ideas online. I mean, there\u2019s a whole Facebook group for people who drink urine for health reasons.\u201d<\/p>\n The parasite-cleanse trend could be a product of simple fear \u2014 a collective psychological response to a world that feels like it\u2019s invading us. We\u2019re told constantly that our bodies are full of things we can\u2019t see: forever chemicals, microplastics, phthalates, Bisphenol A, mercury, lead. We don\u2019t know where our food comes from; it just shows up in the grocery store in a way that feels both mundane and sinister. Who touched it on its way there? What touched it? I ask Griffin what he thinks about it all. What would possess someone to believe they were crawling with worms?<\/p>\n He thinks it might be that no one has helped them feel better \u2014 that they\u2019re sick and suffering, and seeing a doctor hasn\u2019t helped. \u201cIf a person isn\u2019t feeling well, and they\u2019re searching for answers,\u201d says Griffin, \u201cand they find something that might give them one, they don\u2019t want that taken away.\u201d<\/p>\n This article is for informational purposes only and is not intended to serve as medical advice. Consult your doctor before undergoing medical treatment.<\/p>\n Stay in touch.<\/p>\n Get the Cut newsletter delivered daily<\/p>\n Vox Media, LLC Terms and Privacy Notice<\/p>\n