Eosinophils rise in response to hookworm infection, seeming to peak between weeks 3-10. This study describes that eosiniphils peak between days 38-64 :

http://www.ajtmh.org/cgi/content/abstract/37/1/126

Peaks between weeks 3-9:

http://www.ajtmh.org/cgi/content/full/75/5/914#F5

Starts to be elevated at days 14-21, peaked on day 42 and declined to
a persistently elevated level:

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1809522

Peaked week 5, declined by week 20:
“In the CD cohort, blood eosinophilia developed from week 5 (mean
2.60×109/l (1.89) v week 1 0.18×109/l (0.10) v week 20 0.59 (0.20)). ”

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1856386

But my favorite study, the MS study in Argentina, where they tracked 12 MS patients already infected with helminths and compared them to 12 other MS patients over a 4.6 year period, only recruited the helminth infected patients if their eosinophelia was high, (800-1800 mm3) and it stayed that way for the duration of the study. Their quantitative egg counts were also high: between 1,180 and 9,340 eggs/gram.

Eosinophils reflect parasitic infection, and the higher the number, usually the larger the worm burden. One indication that one has lost their worm infection would be having an elevated EOS for an extended length of time, then having it fall to baseline. Obviously, stool tests would confirm this, as well as symptom regression. In the dose-ranging trial, the higher doses resulted in higher EOS counts, though they did not test longer than 12 weeks.

I only tested my EOS at baseline and 18 weeks, so I never tracked a rise and fall. Baseline values were 74 cells/mcL and only rose to 192 post infection. (Normal is 15-550). Remember, I added worms from weeks 10-18, which may have provoked an immune response that curtailed the new worms from attaching, and possibly displaced some of the first 10, like this capsule endoscopy study shows. So by week 18, perhaps I had very few worms…

I will be testing EOS at weeks 3, 6, 9, and 12 to see how they respond to 10 larvae. I don’t think 10 hookworms are going to be enough to cause persistent eosinophilia. And like the MS study, it seems important to get and maintain a large enough worm burden to stimulate eosinophilia, and maintain a higher egg count. I’m very curious what my results will be this time…

Oh, the selection in the hookworm market! I can a) wait and get no more larvae; if I’m not better by X amount of months I can b) get more slowly – 2 or 3 every few weeks or c) get more quickly and possibly suffer the ill effects. I’m impatient. I want wellness now. But which method to choose? I deliberate constantly.

The choice of worm burden seems arbritrary. Throw up your hands and choose between 10 and 50 worms, with no idea of how many will remain, how many at a time will “stick”, how the body will react. Worm Russian Roulette.

This study showed that 2 already infected healthy men, who added 50 worms, ended up with an immune response that basically killed the new infection, or displaced some of the old ones, so that they ended up with the same worm burden they started with:

http://www.ncbi.nlm.nih.gov/pubmed/16890593

So how many to add? Who knows? I don’t want to go back to Mexico to get reinfected. I live in the same town as Jasper, so perhaps we could reinfect locally. I don’t think this therapy should be illegal in the US – if it is proven that we as human animals are meant to coexist with helminths, then we should be able to get free worms, or just pick up a prescription in the larval section of your favorite drug store. But that is probably never going to happen. Most people will have to wait decades for the drug derivative.

But I am a walking scientific experiment. Dr. Pritchard gets the deserved admiration for infecting himself with 50 larvae as part of the dose-ranging trials of hookworm. They define the necessary eggs per gram of stool for therapeutic effect as 50 eggs/gram. All doses; 10, 25 and 50 (the woman who got 100 had to terminate due to relentless vomiting and diarrhea) resulted in the necessary egg count. I should test to see where I’m at, but I don’t know how.

Yet I’m tired, still so tired. Will more worms boost me or simply add to the fatigue? The Crohn’s study is still recruiting, so no one knows yet if 10 worms will be enough. The average worm burden in New Guinea is 25 worms, and one assumes they are gotten in little doses, starting from childhood, not 10 or 20 all at once. Which is where “trickle therapy” comes in. In an interview, Dr. Pritchard said,

“The average worm burden of a person in Papua New Guinea is 25 worms. It’s this sort of level that we think is beneficial. Whether we can mimic this in a hospital in Nottingham is difficult to say, because we’ll be giving ten worms in one dose after the person has already developed allergy. So the trial may not work this time. We may have to go back to ‘trickle infections’ where we give small numbers over an increased length of time.”

So should I try the trickle infection now, for lack of better knowledge? So many choices, just one body to experiment on. What do I do?