Parasitic Infections through a Functional Medicine Lens

Parasitic organisms can sometimes live and reproduce within the body, using the host’s nutrients for survival. Although many believe parasitic exposure is rare in the United States, the Centers for Disease Control and Prevention notes that they remain a common health concern, affecting millions each year.

Illnesses due to parasites can be easily overlooked due to their subtle symptoms, which often overlap with other chronic health concerns. If not addressed, parasitic exposure may be associated with gastrointestinal discomfort, nutrient imbalances, skin health issues, and other ongoing health challenges. 

Functional medicine testing may offer insights into potential parasitic exposure. Some test panels can also provide guidance for supportive wellness approaches that promote overall microbiome health. 

The purpose of this article is to review common parasitic infections, associated symptoms, and effective functional medicine treatment strategies for parasitic diseases.

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Understanding Parasitic Infections

Three predominant classes of parasites—ectoparasites, protozoa, and helminths — are known to cause common parasitic infections and illnesses in humans. 

Ectoparasites: 

Ectoparasites are a type of parasite that lives on the exterior of the host. These include fleas, lice, mites, and ticks. 

Helminths:

Helminths are multi-celled parasitic worms that infect the gastrointestinal tract. In adulthood, they are visible to the naked eye and range from 1mm to 1 meter in length.

Protozoa:

Protozoa are single-cell parasites that can infect the gastrointestinal tract, the blood, or bodily tissues. A microscope is necessary to see them.

This article focuses on protozoa and helminths, two types of parasites that may inhabit the gastrointestinal tract, blood, or tissues. Such exposures could impact host well-being, potentially leading to both short-term and ongoing health challenges.

Helminth Parasite Infection

Helminths include roundworms and flatworms. Most helminths cannot replicate in the host’s body but can mature and lay eggs there. Adult helminths leave the host through the stool, but the eggs remain in the intestine, creating an opportunity for spreading to others who come into contact with contaminated stool. They commonly spread through contaminated food, water, and surfaces. 

Common parasitic infections involving helminths follow.

Roundworms (Nematodes):

Roundworms are small worms spread through infected soil or stool. 

Examples:

• Pinworms (enterobiasis): Pinworms are thin, thread-like worms that lay eggs in the small intestine. 
• Ascaris (ascariasis): Ascaris most commonly occurs in areas where people have limited or no access to toilets and sanitary measures surrounding stool.
• Whipworms (trichuriasis): Whipworms get their name from their shape, which resembles a whip.
• Hookworms (ancylostomiasis): Their hook-like heads allow these nematodes to attach to the intestinal walls and gain nourishment. Hookworms spread orally by ingesting contaminated soil or through the skin if walking barefoot on contaminated soil. 
• Strongyloides (strongyloidiasis): Strongyloides can spread orally or enter the skin if one walks barefoot on contaminated soil. It is unique to other helminths because it can reproduce inside the host.

Tapeworms (Cestodes):

Tapeworms are large, flat worms that resemble ribbons. Tapeworms spread by laying eggs in the host’s intestine. Eggs from the host’s stool spread through contaminated food, water, or undercooked beef, pork, or fish.

Flukes (Trematodes): 

Several species of flukes can cause human disease. Flukes are flatworms that spread through contaminated water or seafood. Flukes can infect the blood, liver, lungs, intestine, and bladder. 

Protozoa Parasite Infection

Protozoa also spread when you ingest trace amounts of stool or soil that contain their eggs, most often through water, fruit, and vegetables. Protozoa are different from helminths because they are much smaller, comprise single cells, and can replicate within the host. The most common protozoal infections follow.

Amoeba: 

Amoebas employ “false feet,” or pseudopods, for mobility. 

Example:

• Entamoeba histolytica is associated with intestinal and can cause mild to severe intestinal symptoms in 10-20% of those infected. Amoebic dysentery spreads through feces.

Ciliates: 

Ciliates are defined by their fine and short cilia, hair-like structures used for locomotion and gathering food.

Example:

• Balantidium coli is the only known ciliate to affect humans. It is spread through feces and causes gastrointestinal symptoms, such as dysentery.

Flagellates:

Flagellates have whip-like flagella, allowing them to assess their surroundings and move around. 

Examples: 

• Giardia intestinalis causes giardiasis, one of the most common parasitic infections in the US. Contaminated feces spread it. 
• Trichomonas vaginalis causes trichomoniasis, a sexually transmitted infection (STI) of the lower genital tract in women and sometimes men. 

Sporozoans (apicomplexan).

Sporozoans are non-flagellated, non-ciliated, and non-amoeboid protozoa. They are unable to move in their adult state.

Examples: 

• Plasmodium causes malaria. Plasmodium spends one part of its life cycle in a human host and another in a mosquito host. Malaria spreads to humans through the bite of a mosquito.
• Cryptosporidium causes cryptosporidiosis, defined as watery diarrhea and spreads through feces-contaminated soil, water, or food.

Symptoms of Parasite Infections

The symptoms associated with parasitic infections vary depending on where in the body the infection resides. Common symptoms include diarrhea, nausea, vomiting, rectal itching, fatigue, muscle aches, and fever. 

In some cases, the patient may have noticed changes to the appearance of their stool or see what they believe to be a worm in their stool. If concerned, patients can consult with a healthcare provider and consider providing a photo for context alongside stool tests. 

However, even without a photo, gastrointestinal symptoms lend to a more straightforward diagnosis of the parasitic infections associated with intestinal illness. Parasitic infections that affect the blood, skin, and genitals can be more challenging to identify.

Diagnosis of Parasite Infections

Diagnostic techniques vary depending on the type of parasitic infection a patient is being worked up for:

Ova and Parasite Test: 

An intestinal parasitic infection is often diagnosed with an ova and parasite test (O&P). An O&P is a microscopic assessment of stool that looks for intestinal parasites and their eggs (ova). 

Several conventional labs employ a one-day stool collection for this purpose. However, functional medicine labs offer more comprehensive three-day stool collection panels. Some panels screen for over thirty parasites and other fecal inflammatory markers, including fecal white blood cells. 

Diagnosing Parasite Infections Outside the GI Tract

The diagnostic techniques differ when a parasitic infection of other body parts or systems outside the intestine is suspected. 

• Physical exams, sputum samples, and imaging may be necessary when the lungs or the liver are involved. 
• Diagnosis of malaria may involve a microscopic blood smear or antigen testing. Vaginal swabs or urine samples are used for the diagnosis of trichomoniasis. 
• Some protozoan infections are easier to identify via PCR methodology. 

The Immune System and Parasitic Infections

A parasitic infection triggers a wide array of immune system responses. The innate immune system resists infection by employing immune cells called macrophages and mast cells to damage the pathogen. 

In addition, the innate immune response calls on T helper cells to release various cytokines, including IL-4, IL-5, and IL-13. These are critical indicators of allergic inflammation that trigger changes in the intestinal tissues to protect the environment and make it less inviting to the parasite. 

White blood cells, also known as leukocytes, play a key role in protecting the body from infection. Leukocytosis, defined as an increase in the production of white blood cells, can be due to the rise in just one particular type of leukocyte. 

Eosinophils and basophils are two types of leukocytes that increase in the presence of parasitic infection. 

Blood testing revealing elevated leukocytes with a differential indicating high eosinophils and basophils favors the diagnosis of parasitic infection. However, it is essential to note that both types of leukocytes may also be elevated in allergic disease. 

Functional Medicine Approaches to Treating Parasitic Infections

Functional medicine is a holistic approach to health, with principles that encourage us to try our best to identify and treat the underlying causes of disease rather than managing symptoms alone. 

From a functional medicine perspective, imbalances in one bodily system can affect other systems and the overall health of the individual. This comprehensive approach to health is why functional medicine treatments for parasitic infections go beyond simply eliminating the parasite. 

A functional health plan may incorporate herbs with supportive properties, aiming to assist immune resilience, maintain microbiome balance, and support the body’s nutritional needs. This integrative approach aims to support the body’s ability to maintain health during exposure-related challenges.

Functional Medicine Parasite Cleanse Protocol

Antiparasitic medications are the treatment of choice for parasitic infection. However, some patients prefer alternative parasite cleanse methods, including those in the functional medicine toolbox. 

Before starting any supportive wellness protocol for suspected parasitic exposure, appropriate testing should be performed to confirm and identify the parasitic species. This is best done through a functional medicine provider trained in physical exams, testing, and treatment. 

Functional wellness protocols to support the body against parasitic exposure generally include four key components: 

• Microbial Support
• Immune Function Support
• Gentle Detoxification Support 
• Nutritional Guidance 

Herbs With Antiparasitic Properties

Many herbs have been well-studied for their antiparasitic properties. These plant properties are known for their supportive effects on general health and may help the body manage microbial balance. The following herbs have been well studied and demonstrated promising antiparasitic activity.

• Wormwood: Well-regarded for its use in traditional wellness practices, wormwood may support general microbial balance. It is rich in an antiparasitic compound called thujone, which is a compound that performed as well as antiparasitic pharmaceuticals in animal studies. In a clinical study, 500 mg administered three times daily was associated with improvements in 70% of patients experiencing Entamoeba histolytica infection.
• Black Walnut: Black walnut contains tannins, which are known to support a balanced internal environment. With a long list of beneficial actions, juglone is highly toxic to many parasites and is effective as a natural herbicide and insecticide. Juglone is associated with inducing oxidative stress in certain organisms.
• Oregano Oil: Oregano is rich in carmacrol and thymol, two substances with proven activity against helminths, among other various microbes. Oregano oil has inhibitory actions on parasitic growth and reproduction. 
• Clove: Clove is rich in eugenol, which provides the herb with strong antiparasitic activity. Eugenol is thought to inhibit growth and reproduction in certain organisms by impacting cell membrane integrity and metabolic processes.
• Garlic: Garlic’s active constituent, allicin, may support microbial balance and digestive wellness. Studies suggest that allicin may support microbial balance by inhibiting growth in various helminths.

Prevention of Parasitic Infections

Several simple lifestyle strategies can be employed to limit the risk of parasitic infection; these include: 

• Frequent hand washing, especially before meals
• Routine bathing with hot water and soap
• Ensuring clean and properly prepared food and water sources before consuming. some text
  • If drinking from a pond, lake, or stream, boil the water for at least one minute before drinking. 
  • Be sure to cook all animal protein to the recommended internal temperature. 
• Protect yourself from insects with appropriate clothing or bug spray. some text
  • If spending time outdoors, check for insects along the scalp, waistline, and difficult-to-see areas.
• Use safe sex practices to limit the risk of trichomoniasis.
• Check your pets regularly for insects and follow recommended antiparasitic practices.

From a wellness perspective, some practitioners suggest incorporating foods such as honey and raw garlic to support a balanced internal environment. Supplementing with probiotics, enzymes, vitamin C, and zinc may also help support the body’s natural defenses.

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Key Takeaways

• The diagnosis of parasitic infections can be easily overlooked due to the curious and subtle ways parasitic infections present, including symptoms that overlap with a variety of chronic health concerns.
• Protozoa and helminths are two types of organisms that may inhabit the gastrointestinal tract, blood, or tissues. Such exposure could impact overall well-being, potentially leading to both short-term and ongoing health challenges.
• Parasitic infection triggers the human immune system in several ways. An elevation of basophils and eosinophils often accompanies parasitic infection.
• The O&P test is a critical tool for identifying and managing intestinal parasitic infections. Three-day collection panels are the most comprehensive and allow for more accurate diagnosis.
• Several plants have properties that may support a balanced internal environment by managing microbial growth. 
• Effective functional medicine treatment strategies include supporting immune function, fortifying the microbiome, and an anti-inflammatory nutrition plan in addition to antiparasitic herbs.