I had a great conversation with a colleague yesterday. We were talking about parasites, chronic infections and cancer. The conventional understanding is that pathogens cause disease and must be eliminated to restore health. This makes sense, on the surface, and it’s certainly true in the case of some virulent infections.
But what’s missing here is an understanding that the body is an ecological system. There are over 100 trillion microorganisms living in our gut alone. That’s 10x the number of human cells in our entire body. When you look at it from this perspective, we’re actually more bacteria, parasites and yeast than we are human.
This is how it works in ecological systems. An invasive species is much more likely to proliferate in the absence of other species that normally inhibit its growth.
A perfect example of this is Clostridium difficile (a.k.a “c. diff”). C. diff is a virulent bacteria that can cause florid diarrhea and, if untreated, death. But consider the following facts about c. diff:
- C. diff infections are most likely to occur after a course of broad-spectrum antibiotics. Why? Because the antibiotics kill the beneficial gut flora that normally keep the c. diff in check.
- At least 20% of c. diff carriers are asymptomatic. Why? Probably because they have enough good gut flora and a strong enough immune system to inhibit its growth.
- By far the most effective treatment for c. diff known today is fecal bacteriotherapy, where the gut flora from a healthy human host is transplanted to the infected person via colonoscope. This suggests that creating a healthy internal environment that crowds out the pathogen is more effective than trying to kill it with antibiotics.
A lot of oncologists and cancer researchers now believe that all of us have cancer. But those of us that are healthy are able to keep it in check. When we say someone “has cancer”, what we’re really saying is that the growth of cancer cells in their body has gone out of control. Or, put another way, we could say that a person with cancer is someone who has lost the ability to fight the growth of cancer cells already in their body.
Likewise, we evolved in concert with parasites.
It’s based on the observation that autoimmune diseases are much more prevalent in developed parts of the world where standards of hygiene and sanitation are higher, and much lower in undeveloped parts of the world where sanitation and hygiene are poor.
In fact, there’s even a treatment for Crohn’s disease and ulcerative colitis that involves patients swallowing thousands of eggs of a particular parasitic worm. They use a pig whipworm that is capable of modulating the human immune system, but not colonizing the human host. This way there’s no danger of chronic infestation, but the patient still gets the “immune tuning” effect. This might be gross to think about, but considering it has a remission rate of higher than 70%, and is virtually free of side effects, it’s far better than almost any other option available for these conditions.
There’s also some intriguing evidence that H. pylori, the bug that causes peptic ulcers, paradoxically may protect against several other gastric diseases. Studies indicate that H. pylori was once more common, perhaps nearly universal in humans, than it is in our postmodern society. Even today, it’s estimated that 1 in 2 people around the world have H. pylori.
This brings the current strategy of completely eradicating pathogenic organisms like H. pylori into question. If we eliminate H. pylori completely, that might help the peptic ulcer to heal, but it could potentially cause other problems. The same dilemma may very well exist for other pathogens.
Instead of focusing on eradicating the pathogen, we focus on supporting the body to keep it in check. Balance, rather than elimination, becomes the goal.
There are certain cases, of course, when the infection is so virulent and the host so weakened that it makes perfect sense to eradicate it completely – presuming that’s possible. But I believe this approach is far too common, and is too often employed in situations where supporting the body’s natural self-healing mechanisms would be safer and more effective.
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