The Worms

The research on helminthic therapy and Crohn's has primarily considered three different species:

1. Human hookworm (Necator americanus or NA)
2. Human whipworm (Trichuris trichiura; Trichuris trichiura ova is abbreviated TTO)
3. Pig whipworm (Trichuris suis; Trichuris suis ova is abbreviated TSO)

Helminthic therapy involves infecting oneself with the larvae of these worms in the case of hookworm and the ova of these worms in the case of whipworm.

Most of the current studies consider TSO because unlike human hookworm and whipworm, the human body isn't the natural home for Trichuris suis and it dies off after only a few weeks and presents no opportunity for reinfection.  This also means one must continuously reinfect oneself with the ova, which if you are a pharmaceutical company is attractive because you can treat TSO similar to any other medication.  A company called Coronado Biosciences in currently engaged in a number of Phase 1 and Phase 2 trials of TSO for Crohn's and other diseases.  TSO is available from a German company called Ovamed and at the doses being tried in studies is quite expensive at over $16,000 a year.

Trichuris trichuria by contrast can live in the body for roughly 18 months and Necator americanus can live in the body for 3 to 5 years.  While these worms can in theory spread to others, modern sanitary practices (i.e. toliets) make this virtually impossible as both worms must live in infected soil under specific conditions and then be reingested (see also CDC's whipworm lifecycle) or exposed to bare skin (see also CDC's hookworm lifecycle).  While there are fewer studies currently considering TTO and NA, the evidence suggests the genetic makeup of TTO is very similar to TSO.  TTO and NA are available from UK-based Autoimmune Therapies (AIT) and Mexico-based Worm Therapy (WT).  See also List of Helminthic Providers.  For both reasons of cost and convenience I have decided to try a combination therapy of TTO and NA from AIT.