Are Pinworms Causing Your Infertility? – #30

0:26 Charlene Lincoln: Welcome back to another episode of The Fertility Hour, and welcome back Rachel Arthur, naturopathic physician. Thank you so much for coming back for a part 2.

Rachel Arthur: That’s alright. Apologies for the sunshine pouring in my window. It’s a terrible problem to have. It’s a good problem to have, but we have a little bit of light.

0:47 CL: Oh, no problem. I was saying to you hopefully people are just listening and it’s not that distracting. You just have a lot of light coming in, so that’s a good thing. Okay, I interviewed you — it just went live on Monday but I interviewed you I think it was several weeks ago about iodine and its titled ‘Iodine Deficiency is a Major Obstacle to Fertility’ because I just wanted to capture people’s attention and to take a look at that. It’s an excellent interview. I just listened to it again myself. I highly encourage you to go back, find that episode of Rachel’s. Amazing. I mean, iodine is an essential, a critical mineral, right?

RA: Yeah.

1:43 CL: And many of us are iodine deficient and as the title implies, it’s a major obstacle to fertility and increases miscarriage fourfold. Is that correct?

RA: Yeah. In certain situations, that’s right.

2:00 CL: In certain situations.

RA: Yeah. We talked about getting that balance right with iodine. Sometimes people are too far under and some people are just too far over. Yeah.

2:12 CL: Exactly. So anyways, I just wanted to stress the importance of listening to that episode. It’s excellent.

So, Rachel is a respected and widely published Australian naturopath specializing in integrative nutrition. With over 20 years’ experience in both the clinic and the classroom, she has become a leading nutritional educator delivering post-graduate training and mentoring to allied healthcare professionals and doctors alike. She has carved out a career as a diagnostic detective, piecing together all the clues from a person’s health history with an advanced understanding of pathology interpretation and biochemistry to form a coherent explanation and blueprint for individualized management. Notorious for thinking truly outside the box and helping the progress of integrative medicine by challenging outdated ideas and introducing new ones that are backed by better scientific evidence, regularly asked to speak at key conferences and contribute work to authoritative texts all the while still maintaining her private practice. Rachel’s ongoing enthusiasm for integrative health and for education makes her presentations both inspiring and empowering experiences for attendees and attract wonderful feedback. And she is a mom to a boy and a girl, 18-year-old twins.

RA: Yup. That’s right. Grace and Will, 19-year-old twins.

3:37 CL: That’s awesome. Wow. You’re almost an empty nester.

RA: I’m almost and it’s just going to be instant by my own.

3:46 CL: That makes me tear up. That’s how much that sort of like hits me.

RA: I know. Finally.

3:51 CL: Well, yeah. You I know. But anyways, then I didn’t know that you had this unique pseudo name/nickname ‘The Worm Whisperer’.

RA: It’s true. So ‘The Worm Whisperer’, it might conjure up the idea of compost in some people’s minds. But in that context, it’s something very different. We’re talking about digestive worms. And it’s a funny way that it came about, Charlene, because probably like I said last time, all my areas of interest that I end up going down are usually generated by clients. And, you know, 8, 9, 10 years ago, I had a series of clients who had a myriad of problems whether it was sleep problems, behavioral problems, genitourinary problems in girls and women. And it turned out that they had worms/digestive worms. Right? But my whole kind of brain exploded at this point because I was like, A, how do you not get rid of worms because we’re talking about threadworm or pinworm in this instance. It’s like that’s a really simple creepy critter, right? Most people can get rid of that. So why are you not resolving it when you’re talking the over-the-counter medication?

And the second thing was these chronic infections in these girls and women in particular, I did see it in young boys as well, there was just this incredible undoing of their health, Charlene. It was mind-blowing how detrimental that was to their health. And I was like, “Oh, okay. I need to go and learn something about this.” So when I was treating those patients, I was madly searching for solutions and I came across really, you know, I was reading all this science trying to understand because there’s not a lot that’s being done on threadworm because everybody goes, “Take the drug.” Like, take the drug, done deal. And because it’s been so underestimated and so sort of trivialized in medicine, nobody is really paying attention to it.

So when I started getting into the science and the literature, I’m looking at animal studies and worm studies and I’m thinking, how do we solve this for these clients? And I struck upon a formula, kind of a formula that I pulled together out of the research, and it worked incredibly well. But from there, I would go out and as you know I educate all over the world and I would be talking to people and I’d always say, “you know, just watch for worms.” And every time, I kind of get these “What? What do you mean?”

6:42 CL: What does that mean? I’d like to know what watch for worms — oh, watch for worms in your patients that you’re treating.

RA: That’s it. Watch for worms in your patients.

6:51 CL: How are they watching for them? Where are they showing up?

RA: Okay. So the trick is that when we think about worms, when we think about threadworm or pinworm, most of us think that person, they had a child, most of us do make the mistake of thinking it only happens in kids which is a total no-no. Very, very common in adults. We think, “Oh, we’ll know that they have worms,” because they’ll have an itchy bottom. No, no.

The research says about 50 percent of patients never present with an itchy bottom. In fact, about 50 percent of patients actually are asymptomatic. They have nothing that you would traditionally think “oh, they’ve got creepy critters in their gut.” So what the first thing is, is broadening our mind about how worms present. Now probably a lot of your listeners know some of these things, if they’ve heard them around the tracks, but there is great scientific support of these ideas. So itchy bottom, I talk about that as being top of the iceberg. It’s the bit that you can see. Okay, if somebody says “I’ve got an itchy bottom,” you go, “Worms.” But, beneath the surface that we don’t recognize so much are things like unexplained nightmares, night terrors, nonrestorative sleep, emotional ability.

You know, I was just looking at a case yesterday. This is again a case report saying that actually someone presented with PTSD as a result of a threadworm infection. So the myriad of mental health problems can be huge. But speaking about women and fertility, again another layer down of that iceberg that people don’t see and don’t associate, is in girls and women. There’s a whole collection of other symptoms that relate to genitourinary. So whether that’s increased needing to urinate, pain on urination, symptoms of urinary tract infection that there’s actually no infection with bacteria; symptoms of thrush, so discharge, itch, pain. And these are the sort of things that most of us would attribute to something else, right? We’d go, you know, you’ve got thrush or you’ve got a urinary tract infection, go take this thing or that thing. But actually, these worms that we all think just live in the digestive tract, most commonly migrate into the bladder, into the urethra, into the vaginal area of girls and women.

Because let me just explain that, Charlene, for people who are going “How does that happen?” These particular worms, the mature worms come out of the anal area at night to lay their eggs. So the mature females come out of the anal area at night within about 40 minutes of going to sleep. They come out to lay up to 17,000 eggs around that anal area. Now, a worm is a couple of millimeters long. The distance between the anus and the genitourinary system of a little girl is not much longer. Okay? And also even in an adult woman, it’s quite understandable that those worms when they’re moving around the perianal area are going to overshoot the mark and we’re into the genitourinary system. Once they get in there, everybody goes, “Oh, they can’t possibly survive in there because they’re digestive worms, right?” The truth is, they do. They survive really well, they set up another little colony in the urinary system or the vaginal system, the reproductive system of girls and women. And the consequences of this are huge. Huge. I mean we can touch on some of the kind of diagnoses that have been associated with threadworm moving into those areas.

11:12 CL: You said that in a lot of cases it’s asymptomatic but then you’re talking about… so I don’t understand. There’s a population of people that have threadworms or pinworms. They’ll never show symptoms of it. They’re just kind of being a host to these worms.

RA: That’s right. And what’s been specifically shown around that is probably that it’s more likely to be men, so a lot of men will carry this worm and not be able to report anything that’s associated with it. So they’re not getting the itchy bum and because it can’t migrate as readily out of the digestive tract to men as it can in women, they’re going, “well, who knows? I’ve got nothing to tell you that I have threadworm.”

I think the other time when we hear about it being asymptomatic, I think sometimes we’re labeling it as that because the patients are not presenting with digestive problems. They’re not going “I’ve got the itchy bottom and the funny feeling,” and, “My appetite’s changed.” They’re giving you a list of symptoms like we just talked about before, and nobody is connecting the dots except for researchers who have gone, “Oh, hang on. Hang on.” This migration of threadworm into the genitourinary system is really common in women. It’s really common and it’s absolutely a potential explanation for reproductive issues in women.

We’ve got studies done here in Australia where even in young, pubescent and pre-pubescent girls, we have a couple of clinicians here in Australia who published a paper saying yeah, this is a thing. This is not a thing just in developing countries or in areas of poor hygiene. This is just a fact because every population is affected by a threadworm and the rates are quite high and if you’re a girl, there’s this chance, unfortunately, that you’re going to get this secondary issue.

13:17 CL: So you’re a woman trying to conceive. You’re having difficulty. It’s been a year plus and you don’t really necessarily have urinary infections or anything like that that would indicate, but you’re listening to this and going, “Okay, maybe I should get that checked out.” So kind of walk us through what’s the…

RA: So one of the tricky things about threadworm has been that it’s hard to test for. So even now, Charlene, what’s considered the gold standard for testing for the presence of this worm, is something that we call here in Australia the ‘sticky tape test’. In America you probably call it the ‘cellophane test’ or something to that sort of idea. You can have every stool test done on the planet. You are unlikely that you got threadworm even when you have it, the detection rate in patients who have the worm and have their stool tested is about 1 in 10. So 10 people have got it but the stool test alone will tell you one time that they have it. Does that make sense, Charlene?

14:31 CL: Okay, right. It’s highly inaccurate for this type of testing.

RA: And it doesn’t matter what stool test you use. You go, “Okay, that’s a problem.” We can’t check your feces, your stool, and say there it is or there it isn’t. It’s really unreliable. So we come back to the sticky tape test. I mean, you call it cellophane.

14:53 CL: I’ve never even heard of the test.

RA: But you know what I’m talking about.

15:00 CL: Well, yeah, like Saran wrap or whatever. Is it actually sticky or is it the stuff that people wrap over food type of thing?

RA: No, no. It’s sticky. I’m actually going to get something out of my drawer.

15:10 CL: Okay, yeah, I want to see it.

RA: We’re probably talking about the same thing. A roll of tape.

15:16 CL: Okay, yeah, tape.

RA: So what this is, is that you are supposed to take a section of this tape and when the individual wakes up in the morning, before they even got out of bed, before they’ve done anything, you press the sticky side down around the anal area. What are we looking for? Well, basically that sticky side is going to pick up eggs because they’ve been laid overnight by a mature female that snuck out of the bottom. So if you pick up that sticky tape, press it down around the perianal area before somebody gets out of bed in the morning, check it for eggs and you can see things that look a bit like sesame seeds. Bingo.

16:03 CL: They’re as small as sesame seeds.

RA: There’s as small as sesame seeds.

16:07 CL: But visible to the eye.

RA: Visible to the eye. They’re kind of color is like a creamy, oval sort of shape. A creamy color, oval sort of shape. The thing is, with the sticky tape test, there’s two things we need to talk about. One is, you’re supposed to do that every morning for 6 days in a row before you can say it isn’t here. If you do it on the first morning and you find the eggs, test no more, right? Because the eggs don’t come from anywhere else. The second thing about the test is that you need to do 6 consecutive days to say there are no eggs here. The second thing which is going to be a little bit harder for everybody to get their heads around, but let’s imagine a person, let’s imagine a woman who thought she had threadworm. She thought she had threadworm because she had an itchy bottom. And so what she did was she went and got some over-the-counter drug for it which most of us would do because it generally works pretty well.

Now, if she took that over-the-counter drug which is called mebendazole, which is the most common drug that’s universally used for this, if she took that anti-worming agent, it only works in the digestive system. It only works in the digestive system. It’s not absorbed and it only works on mature worms. So she takes the drug to clear, to get rid of the itchy bottom and it gets rid of, it does, it works. Is it possible — and the answer is yes — that okay, she’s cleared the worms from her digestive tract but they’ve already relocated into her genitourinary system. Now the stick tape or what we call the sticky tape test, around the anus in the morning, that’s only looking for worms that are living in the gut that are coming out to lay their eggs there at night. You could still have a woman who has no eggs on the sticky tape test around the anus but has everything, all this load of other alarm bells going off about worms in her genitourinary system.

18:29 CL: Can you do the sticky tape to the opening of the vagina?

RA: It’s a question, you know. I do talk about it with patients because we do think that the worms are coming out of the vagina, but you’ve got to be so careful with that area that you might have people that have sensitivities and reactions to the adhesive, so you have to be very careful. What I would say, Charlene, is it’s kind of like we can build a pretty firm conclusion based on bringing all the evidence together.

So let’s go through a hypothetical. Patient comes in, says, “I’ve got reproductive issues” of any description. “I’m having trouble conceiving” or “I have pelvic inflammatory disease even.” You name it. It could be this, right? So they come in and they say, but, you know, the usual kind of explanations don’t seem to fit, so say that they’re presenting with a “thrush-like presentation”. They’re saying thrush treatment doesn’t work. This patient then, you go through the story with them about all the other possible presentations of threadworm and they start to tick some other boxes. “Yeah, I’m not good at night. My sleep is not good.” “I have a little bit of funny urinary stuff” or whatever. You then talk to them about “Do you know anyone with worms? Anyone in your house? Have you got children under 14 (is considered)?” If you live in a house with any child under 14, your risk already jumps up of having threadworm, right? Or still, if that woman can say, “Actually my kids have had worms.” You’re then escalating the possibility again where you’re going “Uh-huh, okay.” So your child has had worms, what’s the possibility that you’ve picked them up very, very high because they’re highly transmissible.

The other thing that I would be looking to is yes, I would still do that sticky tape test but I would also be doing a urinalysis. So a standard urinalysis, you wee in a cup and they put a dipstick in. It’s nothing too fancy. But what I have seen from my experience is that we find that sometimes there are white cells in that urine. Now you don’t normally have white cells in your urine unless you have a bacterial infection. Again, these people don’t have any evidence of bacteria. Not there. But you’ll just see, “oh, there’s white cells in the urine. What are they doing?” Well, the answer is, they’re there in response to the presence of the worm. So this would be if the worms have migrated to the urinary system, you can see this.

The second thing that we would look at is blood tests. So when we look at blood tests, and this is the same for you guys no matter where you are in the world, we have something called a white cell count. And with that white cell count, it tells you all the different members of your immune family really and the cells that are there to defend you. The ones that go up with worm problems and the presence of worms, is something called eosinophils. So it’s this particular white cell type. Now, if I’m looking a patient, she’s come in and she’s saying “I’ve got this kind of repro issues but they don’t quite fit the normal box or no one can help me,” or, “I can’t get pregnant, I’m having trouble,” and we go through all of those things that we just described — who do you know, blah, blah, blah. Then we would also come down to looking at the blood tests and saying if those eosinophils are up according to our sort of reference range, there’s a high probability when we connect all those dots up that the answer to your reproductive issues or urinary issues are actually worms that have migrated there.

22:51 CL: Okay. And then what? So they’re in the vaginal area, in the reproductive. And then what?

RA: Yup. Then the thing is, you’ve got to, again, remember that the standard anti-worming agents don’t work there. They don’t work there. So people get on this terrible cycle where they just take more and more of over-the-counter drugs thinking that it will help but it doesn’t. So you either have to use a different pharmaceutical. So if you want to go the pharmaceutical path, there are pharmaceutical agents that are absorbed by the digestive tract and will reach the genitourinary system. A lot of people don’t want to use those. They’re a pretty hard drug. The ivermectin and the —

23:39 CL: Yeah, they don’t seem ideal if you’re trying to conceive during that period.

RA: A lot of people get a bit nervous about that. But in severe situations you might reach for that. What we’re doing is when I went back, going back to that 10 years ago where I had that client, the very first client was a young girl who could not resolve worms. She had thrush-like symptoms, a labial pain, itching, all of this little stuff but she also had a lot of mental health problems as well. And when I was doing that detective work for her and going, “Well, why can’t she resolve this?” It clicked that it migrated to her genitourinary system. And again, she has raised eosinophils, she had white cells in her urine, it was all there.

When I started going through the literature and saying “Well, how do I treat this without pharmaceuticals?” I came across this evidence from that science because the vet side of things, they’re very interested worms. We’ve kind of ignored them. They’re right into it. They have to be totally on to minimizing worm infestations in animals. So they were looking at different worms but what I gleaned from that was that the way that we are susceptible to worms or the way that we effectively resolve worms all comes down to our ability to make something called glycosaminoglycans. That’s a nice word for early in the morning. You might have heard, Charlene, of things like chondroitin sulfate. Okay. So this is something that we normally associate with your joints; that’s for arthritis. Actually, the research is saying that these glycosaminoglycans are all over your body. They’re part of your inherent defense mechanism. So they kind of protect all your borders and they kind of say “Uh-uh, not here.” You can’t colonize here. That’s what they’re saying to bacteria and to worms specifically. Very specifically to worms it’s these GAGs. And so I thought okay, is it possible that for whatever reason this little girl who was my first client 10 years ago and everybody I’ve seen since, is having trouble making GAGs and could benefit from us supplementing with them. And the answer, in short, Charlene, was yes, that’s exactly what ended up being the thing that broke the cycle.

26:38 CL: Really? Okay. What’s the dosage of this?

RA: It depends on the age of the individual. We worked that all out. But it’s not really high dose. If you’re wanting to, because you’ve got to remember that if we’re just wanting to protect the gut like let’s say this is somebody who just can’t resolve from their gut, say a little boy I treat lots of young boys with chronic worm infestations as well. And if it’s they’re just we need it in the gut, then chondroitin sulfate, when you take it orally, that’s where it’s going to work because it’s not very bioavailable. It’s not picked up really well. So we don’t need to hit them really hard with it if we just want it to work in the gut. If we’re wanting those GAGs and the chondroitin sulfate specifically to work beyond the gut, we want it to work in the reproductive system. We might increase the dose a little bit to make sure that we get enough absorption to get it delivered there but it’s not about mega-dosing at all. And Charlene, we use a whole combination with that. So it’s not a one hit wonder. We have to give a couple of other things just to make sure that the immune system is in absolutely prime condition to resolve the infection.

28:10 CL: We’re in the States and people are listening all over. Can people consult with you if they’re in another country? Because I don’t know how many practitioners are dealing with this or understanding this.

RA: Yeah. Look, it’s such an interesting thing and I said to you before, I mean, how did it come about that I got called ‘the worm whisperer.’ Because I just kept going around and mentioning my experiences and I just had doctors and naturopaths and whoever around the world going “Oh, my goodness. This is a thing that we don’t know about. We don’t know what to do about.” I realized that I needed to keep the message going. So the Worm Whisperer, definitely people can get help from us. We have a team working with thewormwhisperer.com.au and we do many consults with people so that we can just talk worms. So much fun. We can just say let’s look at your evidence — yes, it’s a thing; no, it’s not. We can help people to break the cycle. We also have a lot of recordings and things so people can learn a little bit more whether you’re a practitioner or a patient, so people can understand how this is coming about and what they need to do in addition to the supplements to really wave goodbye to these guys forever. So it’s quite a process. Because it’s highly transmissible, Charlene, I mean, one of the things that always freaks audiences out is I say, “Do you know that you don’t even have to ingest the eggs?” because of course that’s normally how we keep re-infecting ourselves. Somehow the eggs get on our fingers whether we’ve been scratching, whether we’ve touched something that someone with the worms has had and we ingest them. But just to make things even more crazy, you can actually just inhale the eggs. The eggs live in the dust and on soft furnishings and things like that and they stay viable for up to two months.

So you’ve got a little kid in the house, you thought you did the right thing and you did a great job, I’m sure. You wormed them when they talked about an itchy bottom and you wash their bedding and you wash their pajamas. Is that the end of the story? Unfortunately, not. The research says that the eggs really get spread far and wide around the house. As I said, it can be in dust, it can be in soft furnishings, it can be on toys and things like that. And they stay active for two months and you can just inhale them and then you’ve got threadworm. They say historically, Charlene, I’m a bit of a nerd, they say that we never had worms, humans never had worms until we moved into caves and we started cohabitating. Maybe our modern-day caves are also part of the source of reinfection. So when we were living independently, it didn’t add up. But when we share houses, we just keep regifting these creepy critters.

31:38 CL: Yeah, I’m really just trying to stay calm with this because I mentioned last time many years ago reading that Hulda Clark about parasites and it was just kind of the same message and it was overwhelming. It’s kind of overwhelming but I think it’s important to know. I don’t know if this is just a stupid question, but if you have a strong immune system and you’re really not showing kind of signs and symptoms of it, can you harmoniously live with these worms in your body or are they going to take you down at some point?

RA: That is such a great question, Charlene. Because there’s a lot of good news about worms. Right?

32:26 CL: Please give us some, Rachel. I need some right now. I need a life line.

RA: First of all, I want to go back. Before I answer that, can worms be good? The answer is yes. I’ll talk about that in a moment. But before I answer that, I want to go back to pull everybody back from the edge of the cliff and say, are there people that I see who think they’ve got worms and they don’t? The answer is yes. There are plenty of people who do not have worms. Plenty of people. It does seem to be, Charlene, that we’re all exposed to them. The eggs are. You know, I’ve read some horror papers. But eggs are kind of everywhere. So it comes down to this individual susceptibility which is why I started really digging around in about the GAGs and all that sort of stuff. So I think you are right in the sense that probably for a lot of us we get exposed and we resolve them. Not everybody in the world is going to have a worm issue and it’s going to be the source of their problems. No. That’s not real. But what we’re kind of trying to tap into is that it is underrecognized. Like one of the papers I sent you, it’s like there are these researches going and obstetricians, gynecologists, you know, listen up. This is just a thing that we’re not talking enough about but we know that it happens.

Okay, so to go back, Charlene. Could worms be good for you? The answer is yes. There’s a lot of research coming out now and you might have heard about this even around the idea of worm therapy. Give somebody worms in order to reduce their autoimmunity or in order to improve their immune system.

34:26 CL: Yeah, I haven’t, but okay.

RA: Yeah. So this is a new area that’s really opening up and in particular they have been doing clinical trials where they have been inoculating people not with threadworm, with a different worm in order to treat, say, Crohn’s disease, like a really horrible autoimmune condition of the bowel. And they’re getting some interesting findings. Now, the theory is, that rather than the worms having a detrimental effect in that scenario, the worms actually, they suppress your immunity. Right? In a way because if you’re autoimmune —

35:07 CL: Hey, hold that thought for a second, I’m sorry. I recorded ‘home’ and my daughter is home from school. Hold on one second. She’s just yelling my name. Hold on one second.

Anyways, sorry. I kind of broke up. Rachel was explaining when worms can be beneficial. But you’re talking about the suppression of the immune system as well.

RA: I am and I’m saying that obviously in some patients who have an overactive immune system, you can see that maybe worms will be beneficial. So let’s keep it a bit more real, Charlene. The research is really suggesting that to have had threadworm at least once in your life is probably a good thing. That is what it’s suggesting. That period, you might have had it once, you might have had it twice as a child, that does help the immune system to kind of settle down, kind of possibly be less likely to develop an autoimmune condition later in life. But the idea that they could be symbiotes, that they could just live in your gut long-term and you could be good with that, no. Because let’s just think about this really simply. If they are immunosuppressive, I get that in clinical trials where you’ve got people with horrendous autoimmune conditions, that’s helpful. For the rest of us, immunosuppression, you go, “No, that’s not a path I want to go down.” And it makes us less able to defend ourselves against basic little things like bacteria. Of course the immunosuppression, the threadworm, the pinworm, whatever you want to call it, Enterobius vermicularis, that worm has to get you to suppress your immune system. Because otherwise you’ll kick it out. So if it’s really interesting, it’s attempting to form this long-term fabulous marriage with you, but it’s not ever a really healthy one for humans.

37:28 CL: What are your dos and don’ts? Like what is your list of “I would never do this” knowing about how common threadworm or pinworm is? Like “I would never sleep my cat” or kind of run down some things that you feel that’s just going to increase your…

RA: I’m really glad you asked that question. So here’s a big myth and we have on The Worm Whisperer, on our Facebook group we have a free e-book that goes through all the myths, goes through lots of solutions The first big myth is that the worms come from your animals. They don’t. This particular worm, threadworm or pinworm —

38:09 CL: My cats, I have few. She’s made her home in front of the bed.

RA: So this worm that we’re discussing today, threadworm or pinworm, it actually only uses humans. Humans are the only hosts. So whatever worms your cats and dogs have, so we have a thing in our e-book that says your pets are innocent, leave them alone. So yeah. It’s not about the animals. I think the biggest thing really is what you’re getting at, is the dos and don’ts, is really understanding how to minimize the re-gifting in families, and even the what we call auto or self-infection. So how someone ends up with an infection for months and months and months is often because they’re just re-infecting themselves over and over again through picking up the eggs and re-ingesting the eggs.

So there are a lot of things you can do that can really change that. One of the biggest things, I mean there’s so much to go through, Charlene, so I was picking out a couple of kind of highlights, I think one of the biggest things is probably many of us know that when individuals are infected by worms, they will start becoming overly interested in their nose. So kids become nose pickers, nose rubbers, sticking their fingers up in their nose. Now, here’s a boggling fact for you. The reason why they’re doing that is often because if they’ve got eggs on their fingernails which most little kids do have if they have the worm, they’re actually implanting those eggs in their nasal lining and that causes low level irritation and all of this sort of stuff. So then they start to get really interested in their nose, itching, rubbing, putting their fingers inside.

So one of the things that we do apart from shortening the nails, of course we don’t need get them with worms, is we use a saline spray in the nose every morning when they wake up, every night before they go to bed. What we’re doing with that saline nasal pump is we’re just flushing those eggs out because again, you can have done everything that’s good for your gut and their bottom and whatever, but this could actually be the source of the reinfection, actually the eggs sitting in the nasal passages because they got back in your gut. Does that make sense, Charlene?

40:54 CL: It does, yes.

RA: Yeah. So we’ve got a huge list of do this, don’t do this, do this. It’s not a lifelong punishment. It’s just while you’re trying to break the cycle and you’re really trying to get clear of this for your whole family, it’s a really clear cause that says okay, this is how you’re going to do it.

41:18 CL: These are just things that are coming out of my head, like is eating sushi on that list?

RA: No. So sushi, again, you’re right when most people when they think of worms, they think of their pets, they think of foodborne worms. Not with this species.

41:44 CL: But someone can have the eggs on their fingertips and then they’re not scrubbing out, they’re not preparing for surgery when they make your food. A lot of them are wearing gloves now. Which that is a really good thing.

RA: That’s right. They should be wearing gloves.

42:00 CL: I saw that you were mentioning certain countries which kind of broke my heart. I was like, “oh,” those are like my favorite places in the world. Even some that I have not traveled to but I know like Sri Lanka, I was like, “Oh, those are the places.” These tropical or Southeast Asian countries where it’s most prevalent. Is it?

RA: Not really.

42:19 CL: Oh, okay. I thought that I read that on your website.

RA: Well, this is another big myth. Is it more prevalent? Okay. I’m going to backtrack. It is but it’s not because of the climate. It’s not because of the soil. It’s not got anything to do with that. If they’re more prevalent in Southeast Asian countries, it’s because of a lack of education. Right? So people go, “I know an itchy bottom was not a good thing and that in my family and I didn’t know about washing my hands.” Okay. It’s not about a region. It’s about the education level and the hygiene standards. That’s all it is. You look at a developed country like Australia and we know that, and I also have some stats from the States as well that suggest that this threadworm is three times more common than head lice. And you go, “That’s in a developed country.” This is not going to only affect people who don’t know about handwashing. Again, that’s one of the big myths.

43:32 CL: We’re almost wrapping up but before we go again, let’s talk about some of the indicators that if someone was listening and a lightbulb went off in their head, “Maybe I should look into this further, what’s coming up.”

RA: Look, I think a lot of the indicators, the biggest ones are if the shoe fits. So if you go, “Wow, I have exposure to these worms,” they’re not just everybody’s got exposure. You’ve got somebody in the family, someone in your loved ones circle who has had worms, already you’re going, “Okay, it’s possible.” If the shoe fits in terms of the clinical picture, so yeah, wow that kind of sounds like me, I got urinary stuff that doesn’t make sense or reproductive stuff or terrible sleep, grinding my teeth at night is another clear one of the features of threadworm for some people. So if you’re doing all this and you’re saying this is starting to not just beat hysteria, I’m starting to actually see several dots that connect. So I’ve had the exposure more than others, I’ve got some clinical features that sound like they could be consistent and then if you want to go to the next level as we talked about and this is unfortunately where you might have to stir it alone or come see us at The Worm Whisperer because as you said, a lot of prackies will not be that familiar with this. Getting a urine test, having a little blood work, looking for what we call those secondary markers of an infestation. But that’s it. I don’t think it’s that hard in the end to be able to say it is or it isn’t. Certainly not for us it’s not that hard and then to say okay, I need to do something more than the over-the-counter medication because that is not going to touch this.

45:39 CL: I love that sticky tape test obviously because of the simplicity of it and if you did the 6 days in a row and you saw some indication of eggs, then what is the probability that if you’re a woman that it’s also gone into the vagina?

RA: They actually haven’t quantified this. That’s a good question, Charlene. They just say it is very common but they don’t say how common. What we do know is that 30 percent of women who present at their gynecologist or at their obstetrician for whatever, endometriosis, pelvic pain, even irregular cycles have been shown to potentially be this worm. So whatever they’re presenting with, 30 percent of women are found when they’re thoroughly investigated to actually have worms in the genitourinary system. So that’s a pretty high strike, right?

46:36 CL: That’s really high.

RA: It’s not everybody but it’s just under a third.

46:40 CL: So that brings up the other question. If you have pelvic inflammatory disease, endometriosis, that could be the underlying causative factor.

RA: It could be. We are talking about there are published case reports where a woman is presented and she’s got PID and they’ve done internal laparoscopies and they’ve gone, “Oh my gosh. We know that this person, the driver is worms.” But they’re rare. Okay? They are published. We have a number of case studies that say that in different women. But every PID patient is not going to be worms. It’s just one of those things that we should make sure it’s on the least of possibilities that we’re keeping our eyes open and saying, “Well, have we really ruled that out?”

47:33 CL: Right.

RA: Yeah.

47:38 CL: Wow! How do we find out more about The Worm Whisperer? What’s the website again?

RA: So we have the website which actually takes you direct to our Facebook page and our Facebook Group. So it’s just TheWormWhisperer.com.au and that Facebook group and page gives you heaps of resources. We keep everybody in the loop with new information. You can personal message us from there if you have specific questions. But also you can access things like 30-minute Worm Whisperer consults and also some of the products to break the cycle. If you do go through that and go “Wow! This is really happening for me,” then you’re going to need some of that help as well.

48:29 CL: Thanks so much for doing the work that you do. Really appreciate it and I feel scared but enlightened somehow. Okay, thank you so much, Rachel. And I’ll reach out to you in a few weeks when this is published. Thank you so much.

RA: Fantastic. Thank you very much. Great to talk to you again.

48:47 CL: You too. Bye-bye!

RA: Bye!