Why acquiring hookworm the old-fashioned way is a baaaad idea

I was asked about a month or more ago to address the topic of acquiring hookworm as I did the first time, and the dangers inherent in doing so. By which I mean going to Cameroon and walking barefoot in the latrine areas of the locals, as I described shortly after doing so here.

The person who contacted me was rightly concerned at posts he had read of people suggesting that they do just that, to save on the expense of purchasing hookworm.

As I describe in the post linked to above, before I went to Africa to get hookworm I considered the many risks associated with doing so, and I only accepted those risk because I had spent 18 months scouring the internet for sources of hookworm, or any other of the various types of helminths I considered safe.

I could not get the ova or larvae from laboratory supply companies, from universities with parasitology departments studying the organisms, nor by locating the areas in the USA where hookworm infection is still endemic because so many people in the S. Eastern US, and Appalachia in particular, still live as they did before Rockefeller’s eradication program began in the 1920s. What every health department I called, in Georgia, Mississippi, Kentucky, Tennessee, Alabama, Louisiana and I am sure a few others, all said was something like, “I know we do have cases in our State, but it is not a reportable disease, and so we have no idea where you would find people with hookworm infections”.

I contacted the various universities with parasitology program, I lied, cajoled, begged, offered to pay large sums, i tried to enrol in the programs at Nottingham (the only then active study, into allergies, was full).

I emailed or called every laboratory supply company I could find, no dice. The closest I got was a dead adult hookworm mounted on a slide for parasitology classes.

I tried everything to avoid going abroad to acquire hookworm for the following reasons:

The high risk of acquiring mosquito borne diseases like Malaria, Dengue fever, Filariasis (leading to Elephantiasis, incurable). Those borne by other insects, like trypanosomiasis (sleeping sickness), West Nile Virus (Nasty!!!), Leishmaniasis (avoid the photographs), the Plague and while most forms are treatable pneumonic can be fatal in less than a week and the mortality rate if untreated is 100%.

Obtaining medical care in Africa is not a happy prospect if you really need it. For instance when I visited the hospital in Limbé the regional capital, when I approached the building I thought the hospital must be behind it because this building was clearly intended for keeping animals. I am deadly serious.

Medicines, including clean syringes had to be supplied by the patients, which is why if you to to Africa besides your anti malaria’s, antibiotics for cholera, shots for typhoid, and cholera (not very effective and makes you feel like dog meat), shots for all the hepatitis versions, etc., you have to take a supply of various syringes so you can be sure of not having one reused on you.

After all the official rate of HIV infection in Cameroon is about 20%, and given that life expectancy there is 47 this means that probably about 50% of adults in Cameroon are HIV positive.

Yellow fever of course, but a requirement of entry to countries where it is endemic is proof of inoculation. Which is good because it destroys your liver in a trice. Then there is Typhus fever (interesting thing: “The first reliable description of the disease appears during the Spanish siege of Moorish Granada in 1489. These accounts include descriptions of fever and red spots over arms, back and chest, progressing to delirium, gangrenous sores, and the stink of rotting flesh. During the siege, the Spaniards lost 3,000 men to enemy action but an additional 17,000 died of typhus.”).

Don’t forget TB, much of which is now totally resistant to antibiotics, interesting thing it can affect your bones as well as your lungs, so your bones crumble away.

Getting bored with listing diseases, there are too many more to want to continue, so just going to list the highlights, you can look them up on Wikipedia: Leptospirosis, Lassa Fever, Ebola & Marburg Viruses (your hemorragic fevers), Schistosomiasis, Rabies, Diphtheria, etc., etc., etc.

Then there are the water borne diseases, meaning you have to stay away from fresh water, whether flowing or still. Don’t forget all the large predators, some that live in water that are above you on the food chain in Africa.

My favourite story was of a German tourist who was told not to swim in the lake by the hotel he was staying in, heedless of the advice he did just that, and was a crocodile’s dinner as a result).

Hippos eat people, too.

There are many other diseases, among which are Polio. If memory serves the eradication effort failed because a bunch of religious lunatics in Nigeria refused vaccination at the end of the global eradication program, Cameroon is next door. But I am getting tired of listing them, that last link takes you to the CDC page for travel advisories for Cameroon and I think lists most of the diseases.

Of course the greatest danger to life and limb in Cameroon does not come from disease or predators, although there are tigers on Mount Cameroon, the second highest mountain in Africa, and it’s largest active volcano. I walked up part of it and down to where it had bisected the road to Nigeria, the flow was enormous.

No, the greatest danger to life and limb in the third world comes from the citizens of the country you are visiting most of the time.

The only guide book to Cameroon warned that cars were the greatest risk, I laughed at that given what I had read about the diseases. But so it proved.

In just two weeks in the country I came upon three accidents, shortly after they had happened, involving fatalities. In one memorable case four in one car that had burned. Quite an image, plus countless others, not involving fatalities, one involving a large gravel truck, a minibus, and a motorcycle.

The minibus had been tossed down the slope next to the road and its contents and passengers distributed at random hither, thither, and yon, along with all their possessions. They seemed to be in the worst shape, the motorcyclist seemed fine, but the passengers in the minibus were all moaning and gripping various body parts, heads in particular.

I was once in a taxi that was one of four cars simultaneously overtaking another car while two cars, one overtaking, came at us in the other direction.

Exciting!

There are no driving tests, few seat belts, no visible police outside the capital, no road signs, only one paved road (from the capital to the oil refinery) that I saw outside the capital, no signs, or road markings. There are only a couple of fire stations in the capital, and I doubt even that many in the rest of the country. Both are quite near the presidential palace by some freak of chance.

As to an ambulance, forget it. If you cannot get yourself to the hospital you aren’t going to make it, and even if you do, see description of hospital in Limbé as reference, I would not rate your chances unless your wounds were very superficial.

The drivers all navigate by honking constantly, as if an audible warning, amongst 3-15 all at once is a license to do just about anything.

The taxis are interesting, I and my traveling companion who I took with me so we could take turns sleeping in dodgy situations, and glad I did, got in a taxi, paid our fair, and waited to take off. Bear in mind almost no one owns a private car in Cameroon, most cars on the road are taxis, and almost universally they are Toyota Tercel sized vehicles that are exported from Germany by the container full, after they fail their road worthiness tests and are deemed by their owners not worth fixing.

We were waiting in one such vehicle, and as the morning rush hour, almost all on foot, passed by the taxi driver slowly filled the Tercel up until there were five passengers in the back seat, and two in the front passenger seat, of which I was one. Then we set off.

When we arrived in the country, in the capital Yaoundé, at night, we got a taxi, were greeted by a woman with skirt hiked to mid thigh standing with legs apart pissing in the street immediately we left the airport.

Within five kilometres the taxi had run out of diesel, so the taxi driver took part of his fair in advance, flagged down one of his friends driving by in another taxi and disappeared into the dark to fetch some diesel. He returned with a one litre soda bottle full of diesel about a half an hour later, and off we went to the capital. All dirt roads.

Then there is the issue of wealth, Cameroon and countries like it where the money economy shows an average daily wage of about a dollar fifty US a day and where family sizes are large, means that parents frequently watch their children die for lack of medicine costing a few dollars.

Such people, when confronted by a white man, perhaps the first they have ever seen as was the case with many I met, must know that your pocket change represents one to three months wages. Ask yourself if you would hesitate to rob, or even kill, to get that money living in that situation. I know my children would come before some white asshole from a country so rich, and that cared so little for the world’s poor.

I heard many stories relating to Cameroonians returning from living in America having saved enough money to build a nice house (about $25K for a four or five bedroom mansion of you are interested) being taken for a ride on the Bay by their old friends and ending up as fish bait for the money in their pockets. I was offered almost a kilometre of beach front property outside Limbé for $10K.

Life is cheap in places like Cameroon, and if you go there you can expect to be exhausted from the constant danger, and the tension it causes.

The last night we were there we spent at a deputy chief of police’s house in Yaoundé, the capital. When we woke up, thanks to the Mosque broadcasting the morning call to prayer at dawn and all the roosters crowing their guts out, we found the power was out. We soon realised it was just the house we were in. What had happened was that someone had stolen her electricity meter, while the power was live through it, in the middle of the night.

She was not surprised, apparently it happens quite often, but not always with a successful outcome, of course. That is how poor people are.

Before I went there I reasoned that I was most likely to return without any disease, next most likely to return with the wrong disease, and would be lucky to return with hookworm.

My original plan was to work with the local pathology labs and doctors to identify infected children, collect a stool sample, culture it (easy in its natural environment) and so infect myself that way.

I quickly learned that that level of poverty makes everyone corrupt. It is not just the ruling class, everyone is on the make, and being white you are the best opportunity to come along in a long time. It took me about four, wasted, days to work out that the doctors and labs were just waiting to see how much I was willing to pay, and that there was no guarantee I would get what I paid for at all.

It was only then that I resorted to walking barefoot in latrine areas.

One can consider such a thing and believe it will be easy to do, but when the time came the only thing that made me do it was the thought of returning home to all those who had decided, clearly and often expressing naked derision, that I was a lunatic for considering infecting myself, never mind going to Africa.

The thought of having to tell them that I did not have the balls to do it was all that compelled me to do it in the end.

Then there is the cost, once you add up the price of two plane tickets, one for you and one for your wingman, all the other travel expenses (the vaccinations are a killer), etc., it is certainly far, far cheaper to buy it from one of the providers.

Plus the outcome is certain, there is no guarantee you will come back with any disease, let alone the right one.

So unless you want the adventure, and I have to admit Cameroon made me feel more alive, and more appreciative of living in the West, than anything I have ever done, I suggest you be sensible and just buy it from someone.

Our policy is that no one is turned down for therapy on the basis of the inability to pay.

If you are pissed off with the price and think it should be cheaper, you know, based on cost of the raw material, I suggest you read this post.

I did what I did only because there were no alternatives, if I could have bought it, even at double what we charge, especially given my experiences in Cameroon, I would have.

I was very lucky, I met a cousin of the Prime Minister on the plane there, and her husband who managed a French owned banana plantation. They happened to live in the darkest area of the map provided by the WHO showing the highest rates of hookworm infection in Cameroon, Limbé. They kept me prisoner once we arrived in town, I kid you not, until they had convinced me and my companion of the danger we were in traveling around the country.

To persuade us to stay with them they went so far as to lend us his car and driver for the duration of our stay. I doubt you would be so lucky, and without that I am pretty sure we would likely have been in grave danger.

They employed six or so people around the house, one of which worked from 6 am to 6pm, and another the other twelve hours. The guy who worked during the day walked around the walled grounds all day with a revolver and machete, and the night clerk slept on the bare tile floor in front of the front door with a gun and machete in his hands, all night. No pillow, no blanket, no mattress. A hard man, a serious man, a man without a sense of humour.

The windows were all barred, the doors all locked with multiple locks, and the man of the house had multiple hand guns to back up the guards.

That is the third world, and if you think visiting it is a bargain compared to buying a sterilised dose of helminths from us, go right ahead.

But don’t say I didn’t warn you, and make sure your life insurance is paid up, and that your will is up-to-date.

Can Hookworm Cause Anaemia in Therapeutic Numbers?

I have asked each of the PhDs who work for Autoimmune Therapies to write articles and reviews of scientific papers on the subject of helminthic therapy, the Hygiene Hypothesis and Old Friends Hypothesis, etc.

I have done this because so much of what is discussed online regarding helminthic therapy is uninformed or based on folk-knowledge, much of it being flat wrong.

Of course a great deal of the research and what is known is very difficult to find, and even harder to understand.

I and those of us who work at Autoimmune Therapies have been studying the subject for years.

I have been reading about the life-cycle of hookworms and whipworms, the Hygiene Hypothesis, and Old Friends Hypothesis, as well as the impact of infection with either hookworm or whipworm on the human immune system, since June, 2004. That was when I first encountered the concept of the Hygiene Hypothesis and the work of Dr. David Pritchard, and others, thanks to my aunt.

One of the most misunderstood aspects of hookworm is their potential to cause anaemia. I have read on someone’s blog for instance that a single hookworm can take up to six pints of blood per day. The person writing the post apparently is not aware that we each have roughly only 8 pints of blood. Or that an adult hookworm is only about one centimetre long and a half a millimetre wide. It is hard to imagine how so much blood could be consumed by such a small organism.

But how much blood does a single hookworm consume in a day?

That depends on which species of hookworm we are talking about. Here we are discussing Necator americanus, the kind that Autoimmune Therapies uses. We selected N. americanus instead of Ancylostoma duodenale because N. americanus draws much less blood, and lives far, far longer than A. duodenale.

According the various parasitology texts and papers I have read that examine this subject the most commonly quoted figure is 0.01ml/day per adult hookworm. Which works out to be 0.3ml/month, if the month has 30 days.

To put that amount in perspective a teaspoon contains about 5.0ml of liquid if filled to the top.

The second most commonly quoted figure for daily blood loss per adult hookworm is 0.03ml per day. Which gives a monthly amount, for a thirty day month, of 0.9ml/month.

The respective amount of blood lost to an infection with 50 hookworm each 30 days then must be between 15ml – 45ml.

In comparison the range quoted on Wikipedia for blood lost each month to menstruation is 10ml – 80ml being considered normal, and 35ml/month considered average.

So clearly, unless you have some disease that leads to blood loss or can cause anaemia, a therapeutic number of hookworm do not represent any risk of anaemia, because clearly the body can cope with a monthly blood loss of at least 100ml without problems.

But how much blood loss per month can humans tolerate, after all a menstruating woman with hookworm might be a risk of anaemia.

Marc wrote the following discussion of the body’s ability to replace lost blood in reply to a thread on the Yahoo Forum on this subject. If you are interested the thread is here.

“Just a note on blood loss, depending on the source the upper limit of average blood loss due to menstruation is 80-100 ml per month. Assuming the highest level of blood loss per worm is 0.03 mL/day which is the most commonly reported higher amount for N. americanus, this equates to 63 ml/month for 70 hookworms (note that AIT provides 35 hookworm as the most common therapeutic dose, although up to 100 will be provided if necessary).

To put this into context, a woman donating blood will give (in the UK) 470 ml of blood per donation without any adverse consequence. The average adult can lose up to 15% (approximately 800 mL) of their blood suddenly without clinical symptoms. So even if we assume 126 mL of blood loss per month to hookworm, double the known amount taken by hookworm, the body is easily of capable of replacing this.

To demonstrate the ability of the body to cope with chronic blood loss, the following calculation may be useful, I have used a blood loss that is double the maximum expected from 70 hookworm which allows for extra blood loss as they move around, at the same time I have assumed the lowest values pertaining to our bodies’ ability to produce Red Blood Cells (RBC).

Therefore, in reality the following calculation underestimates the ability of the human body to replace blood loss from helminths by somewhere between 2 and 5 fold.

We like to be conservative at AIT.

The use of RBC is more appropriate than the use of the total blood volume when evaluating the impact of hookworm on the body’s iron status. It is the RBC that transport oxygen, and it is a decrease in RBC or in haemoglobin in the RBC, that is by definition anaemia. Total blood volume is independent of RBC, and maintained at a fairly constant level at the expense of all other factors.

Assuming there is no reason why normal red blood cell (RBC) production can not be achieved (such as dietary iron deficiency, the normal RBC production in an average male is 18 ml/day. The body can increase production of RBCs by up to six times this value when needed. The average adult male has a haematocrit of 48% (that is each litre, 1,000ml, of blood contains 480 mL of RBC, i.e. 48%). Assuming 126 ml per month of whole blood loss due to hookworm(0.03x70x30x2), this equates to the loss of 60 ml of RBC per month (126×48%).

the human body in that same time produces 540 mL (18×30) of RBC, and can if required produce at least 3240 mL of RBC per month (540×6). Therefore using this worst case scenario, there is an approximate 54 fold excess in the volume of RBC’s that can be produced by the body (3240/60) compared to the amount that are lost to hookworm. For women the calculation is slightly different as the average haematocrit  and the production of RBC per day will be slightly different.

This means that unless there is a significant factor already causing iron deficiency, such as poor dietary intake (malnutrition), or poor absorption of iron, due to dysfunction of the small intestine (or surgical removal as is common with Crohn’s Disease), hookworm on their own in appropriate therapeutic numbers, like those provided by AIT, cannot cause iron deficiency and subsequent anaemia.

Bottom line: There is no risk of developing anaemia if you are provided hookworms by AIT, or know what you are doing and use the appropriate number of hookworm

For the record, I infected myself with a total of 300 N.Americanus and show no signs of anaemia about six months later.

Jasper Lawrence

Can Hookworm Cause Anaemia in Therapeutic Numbers?

I have asked each of the PhDs who work for Autoimmune Therapies to write articles and reviews of scientific papers on the subject of helminthic therapy, the Hygiene Hypothesis and Old Friends Hypothesis, etc.

I have done this because so much of what is discussed online regarding helminthic therapy is uninformed or based on folk-knowledge, much of it being flat wrong.

Of course a great deal of the research and what is known is very difficult to find, and even harder to understand.

I and those of us who work at Autoimmune Therapies have been studying the subject for years.

I have been reading about the life-cycle of hookworms and whipworms, the Hygiene Hypothesis, and Old Friends Hypothesis, as well as the impact of infection with either hookworm or whipworm on the human immune system, since June, 2004. That was when I first encountered the concept of the Hygiene Hypothesis and the work of Dr. David Pritchard, and others, thanks to my aunt.

One of the most misunderstood aspects of hookworm is their potential to cause anaemia. I have read on someone’s blog for instance that a single hookworm can take up to six pints of blood per day. The person writing the post apparently is not aware that we each have roughly only 8 pints of blood. Or that an adult hookworm is only about one centimetre long and a half a millimetre wide. It is hard to imagine how so much blood could be consumed by such a small organism.

But how much blood does a single hookworm consume in a day?

That depends on which species of hookworm we are talking about. Here we are discussing Necator americanus, the kind that Autoimmune Therapies uses. We selected N. americanus instead of Ancylostoma duodenale because N. americanus draws much less blood, and lives far, far longer than A. duodenale.

According the various parasitology texts and papers I have read that examine this subject the most commonly quoted figure is 0.01ml/day per adult hookworm. Which works out to be 0.3ml/month, if the month has 30 days.

To put that amount in perspective a teaspoon contains about 5.0ml of liquid if filled to the top.

The second most commonly quoted figure for daily blood loss per adult hookworm is 0.03ml per day. Which gives a monthly amount, for a thirty day month, of 0.9ml/month.

The respective amount of blood lost to an infection with 50 hookworm each 30 days then must be between 15ml – 45ml.

In comparison the range quoted on Wikipedia for blood lost each month to menstruation is 10ml – 80ml being considered normal, and 35ml/month considered average.

So clearly, unless you have some disease that leads to blood loss or can cause anaemia, a therapeutic number of hookworm do not represent any risk of anaemia, because clearly the body can cope with a monthly blood loss of at least 100ml without problems.

But how much blood loss per month can humans tolerate, after all a menstruating woman with hookworm might be a risk of anaemia.

Marc wrote the following discussion of the body’s ability to replace lost blood in reply to a thread on the Yahoo Forum on this subject. If you are interested the thread is here.

“Just a note on blood loss, depending on the source the upper limit of average blood loss due to menstruation is 80-100 ml per month. Assuming the highest level of blood loss per worm is 0.03 mL/day which is the most commonly reported higher amount for N. americanus, this equates to 63 ml/month for 70 hookworms (note that AIT provides 35 hookworm as the most common therapeutic dose, although up to 100 will be provided if necessary).

To put this into context, a woman donating blood will give (in the UK) 470 ml of blood per donation without any adverse consequence. The average adult can lose up to 15% (approximately 800 mL) of their blood suddenly without clinical symptoms. So even if we assume 126 mL of blood loss per month to hookworm, double the known amount taken by hookworm, the body is easily of capable of replacing this.

To demonstrate the ability of the body to cope with chronic blood loss, the following calculation may be useful, I have used a blood loss that is double the maximum expected from 70 hookworm which allows for extra blood loss as they move around, at the same time I have assumed the lowest values pertaining to our bodies’ ability to produce Red Blood Cells (RBC).

Therefore, in reality the following calculation underestimates the ability of the human body to replace blood loss from helminths by somewhere between 2 and 5 fold.

We like to be conservative at AIT.

The use of RBC is more appropriate than the use of the total blood volume when evaluating the impact of hookworm on the body’s iron status. It is the RBC that transport oxygen, and it is a decrease in RBC or in haemoglobin in the RBC, that is by definition anaemia. Total blood volume is independent of RBC, and maintained at a fairly constant level at the expense of all other factors.

Assuming there is no reason why normal red blood cell (RBC) production can not be achieved (such as dietary iron deficiency, the normal RBC production in an average male is 18 ml/day. The body can increase production of RBCs by up to six times this value when needed. The average adult male has a haematocrit of 48% (that is each litre, 1,000ml, of blood contains 480 mL of RBC, i.e. 48%). Assuming 126 ml per month of whole blood loss due to hookworm(0.03x70x30x2), this equates to the loss of 60 ml of RBC per month (126×48%).

the human body in that same time produces 540 mL (18×30) of RBC, and can if required produce at least 3240 mL of RBC per month (540×6). Therefore using this worst case scenario, there is an approximate 54 fold excess in the volume of RBC’s that can be produced by the body (3240/60) compared to the amount that are lost to hookworm. For women the calculation is slightly different as the average haematocrit  and the production of RBC per day will be slightly different.

This means that unless there is a significant factor already causing iron deficiency, such as poor dietary intake (malnutrition), or poor absorption of iron, due to dysfunction of the small intestine (or surgical removal as is common with Crohn’s Disease), hookworm on their own in appropriate therapeutic numbers, like those provided by AIT, cannot cause iron deficiency and subsequent anaemia.

Bottom line: There is no risk of developing anaemia if you are provided hookworms by AIT, or know what you are doing and use the appropriate number of hookworm

For the record, I infected myself with a total of 300 N.Americanus and show no signs of anaemia about six months later.

Jasper Lawrence

The story of how I decided to infect myself with hookworms and the founding of Autoimmune Therapies – Part 1

In late 2000 my company, Words & Images, Inc., was collapsing. First came the event known as the dot bomb collapse, the bursting of the internet bubble. It had a severe impact on my company. Our clients were companies like Cisco, HP, Lucent, Nortel, and numerous technology start-ups in Silicon Valley. By August of 2001 I had stabilised the company, we were profitable again, but the toll on me had been severe. I had had to lay off half our staff (sixteen people), and most were friends. There had also been a lot of conflict with the other large shareholders, I was the largest, and I had had to force out one of them due to incompetence, which also cost money to buy him out. It was a nightmare that lasted for months, that stretched into years.

All this had taken its toll on my health, and my asthma was at it’s worst, probably as a result of stress, and cats (see below). I was suffering from depression, anxiety attacks and insomnia. I was also gaining weight fast, because of the prednisone, the inability to exercise, and on top of that my marriage was crumbling.

Then 9/11 happened, and when it did every client we had in Silicon Valley put a hold on all marketing and advertising projects while they waited to see what was going to happen. Suddenly I was having to lay people off again. Despite this I was able to save the company, in a much smaller form. But it took an enormous toll. Not just on me, and of course everyone I had to lay off, but on my marriage, which was on the rocks anyway because of my wife’s refusal to even keep the cats outside or to help with household expenses from her income working part time.

To give an idea of how rapid and severe the decline in my business was, in November of 2000 our gross sales were $525,000.00. In December of 2001 they were $30,000.00. That is a 94% decline in gross sales in 13 months.

The impact on me was profound, besides declaring personal bankruptcy after struggling on for another few years (a source of enormous shame and embarrassment at the time), I was completely burned-out with respect to running the agency. I no longer found any joy in it, quite the opposite, and the business I had spent almost 15 years building was in ruins. I performed triage and through extreme measures was able to keep the company intact, although now without employees, just freelancers. The result was that I was earning over $100,000 a year again, which given my debt load, even after the personal bankruptcy, was barely enough to get by. But going to work was torture. What had been a joy had become a chore of the worst kind.

On top of that, because I had laid off all my employees, I no longer qualified for group health insurance, one cannot form a group with family members in the US. Not being able to form a group meant that I could be denied coverage for pre existing conditions, asthma of course. I was “offered” a policy that cost over $1600 a month for my family, with my asthma excluded as a pre existing condition, but I could not afford it. So I could not even provide my family with health insurance, and money was now a constant worry. Not being able to provide health insurance for your children is an awful feeling.

In the middle of this my now ex-wife actually managed to save enough money from working 2-3 days a week to get plastic surgery, I kid you not. Refusing to help at all with the mortgage or household expenses, and watching what was going on with me, she decided a facelift was the best use of “her” money. Needless to say home life was not a refuge from work, it was just the opposite.

My asthma was caused by various allergies, primarily to cats. My then wife, for whatever reason, refused to accept this. When our three original cats died of old age all within a year she promptly replaced them, with first three, then four, then five and finally six, more.

I realised that I needed to radically change my life, my relationship, my career and most of all my health.

I had just turned 40, and at that point I was almost 40 pounds overweight, and I am as vain as anyone, for the first time in my life. I was having to visit the ER two or three times a year due to asthma attacks, knew that my wife no longer loved me, and hated every day at work.

At this point I had given up on the idea that modern medicine was ever going to be able to offer me effective therapies for my asthma. The allergies I could put up with. I had had allergies, after all, throughout most of my childhood. There was a period of about five years when I did not, that reinforces the idea of the hygiene hypothesis, that I will describe in a later post. Although they were severe I was used to allergies and could tolerate them.

Asthma was another issue altogether. I had started to develop asthma after being stung by six or seven bees on my abdomen, which caused an anaphylactic reaction. A few months later I developed the first symptoms of asthma. This type of story is very common in those who develop immunological disorders or autoimmune diseases. There is usually a triggering event, it can be almost anything. A case of the flu, a car accident and trauma, bee stings, the death of a relative, etc.

In the years after that my asthma grew progressively worse, but the medications appeared to be useless. I suppose their inhalers and pills kept me alive, but I could not run or even climb a single flight of stairs without having to rest, and the side effects were almost as bad as the asthma. The side effects of longterm use of prednisone are horrible, but prednisone was the only drug that provided real relief when I was having an attack.

In the middle of this, in the summer of 2004, I decided to visit England and take my two daughters to visit my aunt and uncle, who had raised me. I had to get away, and damn the expense. As soon as I walked into their house my aunt’s face told a story: she was shocked at my appearance. Fat, pale and sallow, with dark circles under my eyes, but she was too polite to say anything and quickly regained her composure.

The conversation soon turned to my asthma, and she mentioned a documentary she had recently seen on the BBC about Dr. David Pritchard’s research at the University of Nottingham into the negative relationship between hookworm infection and allergy and asthma.

Despite having given up on ever finding a solution to my asthma this piqued my interest. So I used her computer to go online and find out about this documentary.

What I found instead of the documentary was a few articles about Pritchard’s research, the hygiene hypothesis, and a lot of epidemiological evidence showing that diseases like asthma are almost unknown in the underdeveloped world.

If you are interested you can find some of this research assembled in the Files section of the Yahoo Group I created for Helminthic therapy. Or you can read various sections of Autoimmune Therapies, each disease page includes some of the research available for that disease and helminths.

The hygiene hypothesis, the idea that our immune systems co-evolved with various organisms, most importantly helminths, and that the absence of their immunomodulatory effect on our immune systems

A great resource I found is the online database of medical research maintained by the United States National Institutes of Health called PubMed. The pace of research and publication on the subjects of the hygiene hypothesis and the impact of helminths on the immune system, and with respect to specific diseases, particularly Multiple Sclerosis and IBD, has expanded enormously since I started researching this topic in 2004.

I also researched various helminths, particularly hookworm. When I finally stopped and went to bed, at about 2 or 3 in the morning, I was determined to try self-infection with a helminth or helminths in an attempt to get my asthma under control.

That night I had grey, slithery, wormy nightmares, but in the morning I was still determined to try helminthic therapy as it came to be known.

Little did I realise how difficult it was going to be to obtain hookworm. I was to spend the next 18 months researching helminths in general, hookworm in particular, and trying various methods of obtaining hookworm with which to infect myself.

I will describe the process I went through that lead to my going to Africa, to Cameroon, to obtain hookworm in my next post. As well as the end of my marriage, how I met the woman I love, and whom I married in 2007. How I set up Autoimmune Therapies to provide hookworm to others who like me wanted to try them, and what has happened subsequent to that decision. Including having to leave the United States and being separated from my children, (seven, three of whom are adopted, and two step-children from my second marriage) because of the FDA decision to classify helminths as an Investigational New Drug.

Jasper Lawrence, January, 2011

The story of how I decided to infect myself with hookworms and the founding of Autoimmune Therapies – Part 1

In late 2000 my company, Words & Images, Inc., was collapsing. First came the event known as the dot bomb collapse, the bursting of the internet bubble. It had a severe impact on my company. Our clients were companies like Cisco, HP, Lucent, Nortel, and numerous technology start-ups in Silicon Valley. By August of 2001 I had stabilised the company, we were profitable again, but the toll on me had been severe. I had had to lay off half our staff (sixteen people), and most were friends. There had also been a lot of conflict with the other large shareholders, I was the largest, and I had had to force out one of them due to incompetence, which also cost money to buy him out. It was a nightmare that lasted for months, that stretched into years.

All this had taken its toll on my health, and my asthma was at it’s worst, probably as a result of stress, and cats (see below). I was suffering from depression, anxiety attacks and insomnia. I was also gaining weight fast, because of the prednisone, the inability to exercise, and on top of that my marriage was crumbling.

Then 9/11 happened, and when it did every client we had in Silicon Valley put a hold on all marketing and advertising projects while they waited to see what was going to happen. Suddenly I was having to lay people off again. Despite this I was able to save the company, in a much smaller form. But it took an enormous toll. Not just on me, and of course everyone I had to lay off, but on my marriage, which was on the rocks anyway because of my wife’s refusal to even keep the cats outside or to help with household expenses from her income working part time.

To give an idea of how rapid and severe the decline in my business was, in November of 2000 our gross sales were $525,000.00. In December of 2001 they were $30,000.00. That is a 94% decline in gross sales in 13 months.

The impact on me was profound, besides declaring personal bankruptcy after struggling on for another few years (a source of enormous shame and embarrassment at the time), I was completely burned-out with respect to running the agency. I no longer found any joy in it, quite the opposite, and the business I had spent almost 15 years building was in ruins. I performed triage and through extreme measures was able to keep the company intact, although now without employees, just freelancers. The result was that I was earning over $100,000 a year again, which given my debt load, even after the personal bankruptcy, was barely enough to get by. But going to work was torture. What had been a joy had become a chore of the worst kind.

On top of that, because I had laid off all my employees, I no longer qualified for group health insurance, one cannot form a group with family members in the US. Not being able to form a group meant that I could be denied coverage for pre existing conditions, asthma of course. I was “offered” a policy that cost over $1600 a month for my family, with my asthma excluded as a pre existing condition, but I could not afford it. So I could not even provide my family with health insurance, and money was now a constant worry. Not being able to provide health insurance for your children is an awful feeling.

In the middle of this my now ex-wife actually managed to save enough money from working 2-3 days a week to get plastic surgery, I kid you not. Refusing to help at all with the mortgage or household expenses, and watching what was going on with me, she decided a facelift was the best use of “her” money. Needless to say home life was not a refuge from work, it was just the opposite.

My asthma was caused by various allergies, primarily to cats. My then wife, for whatever reason, refused to accept this. When our three original cats died of old age all within a year she promptly replaced them, with first three, then four, then five and finally six, more.

I realised that I needed to radically change my life, my relationship, my career and most of all my health.

I had just turned 40, and at that point I was almost 40 pounds overweight, and I am as vain as anyone, for the first time in my life. I was having to visit the ER two or three times a year due to asthma attacks, knew that my wife no longer loved me, and hated every day at work.

At this point I had given up on the idea that modern medicine was ever going to be able to offer me effective therapies for my asthma. The allergies I could put up with. I had had allergies, after all, throughout most of my childhood. There was a period of about five years when I did not, that reinforces the idea of the hygiene hypothesis, that I will describe in a later post. Although they were severe I was used to allergies and could tolerate them.

Asthma was another issue altogether. I had started to develop asthma after being stung by six or seven bees on my abdomen, which caused an anaphylactic reaction. A few months later I developed the first symptoms of asthma. This type of story is very common in those who develop immunological disorders or autoimmune diseases. There is usually a triggering event, it can be almost anything. A case of the flu, a car accident and trauma, bee stings, the death of a relative, etc.

In the years after that my asthma grew progressively worse, but the medications appeared to be useless. I suppose their inhalers and pills kept me alive, but I could not run or even climb a single flight of stairs without having to rest, and the side effects were almost as bad as the asthma. The side effects of longterm use of prednisone are horrible, but prednisone was the only drug that provided real relief when I was having an attack.

In the middle of this, in the summer of 2004, I decided to visit England and take my two daughters to visit my aunt and uncle, who had raised me. I had to get away, and damn the expense. As soon as I walked into their house my aunt’s face told a story: she was shocked at my appearance. Fat, pale and sallow, with dark circles under my eyes, but she was too polite to say anything and quickly regained her composure.

The conversation soon turned to my asthma, and she mentioned a documentary she had recently seen on the BBC about Dr. David Pritchard’s research at the University of Nottingham into the negative relationship between hookworm infection and allergy and asthma.

Despite having given up on ever finding a solution to my asthma this piqued my interest. So I used her computer to go online and find out about this documentary.

What I found instead of the documentary was a few articles about Pritchard’s research, the hygiene hypothesis, and a lot of epidemiological evidence showing that diseases like asthma are almost unknown in the underdeveloped world.

If you are interested you can find some of this research assembled in the Files section of the Yahoo Group I created for Helminthic therapy. Or you can read various sections of Autoimmune Therapies, each disease page includes some of the research available for that disease and helminths.

The hygiene hypothesis, the idea that our immune systems co-evolved with various organisms, most importantly helminths, and that the absence of their immunomodulatory effect on our immune systems

A great resource I found is the online database of medical research maintained by the United States National Institutes of Health called PubMed. The pace of research and publication on the subjects of the hygiene hypothesis and the impact of helminths on the immune system, and with respect to specific diseases, particularly Multiple Sclerosis and IBD, has expanded enormously since I started researching this topic in 2004.

I also researched various helminths, particularly hookworm. When I finally stopped and went to bed, at about 2 or 3 in the morning, I was determined to try self-infection with a helminth or helminths in an attempt to get my asthma under control.

That night I had grey, slithery, wormy nightmares, but in the morning I was still determined to try helminthic therapy as it came to be known.

Little did I realise how difficult it was going to be to obtain hookworm. I was to spend the next 18 months researching helminths in general, hookworm in particular, and trying various methods of obtaining hookworm with which to infect myself.

I will describe the process I went through that lead to my going to Africa, to Cameroon, to obtain hookworm in my next post. As well as the end of my marriage, how I met the woman I love, and whom I married in 2007. How I set up Autoimmune Therapies to provide hookworm to others who like me wanted to try them, and what has happened subsequent to that decision. Including having to leave the United States and being separated from my children, (seven, three of whom are adopted, and two step-children from my second marriage) because of the FDA decision to classify helminths as an Investigational New Drug.

Jasper Lawrence, January, 2011

Why helminthic therapy is so cheap

I have seen a lot of posts and received a lot of emails about what we charge over the years. It gets tiresome having the same conversation once a month or so, so here is an explanation I am hoping I can just point people to in the future when the subject comes up.

Believe it or not they come down about equal between our prices being a remarkable bargain and those who believe it should be a lot cheaper.

Before I get into it let me remind everyone that it is our objective to popularise this therapy to that it becomes widely available, and in so doing to drive down the price. The only way to accomplish what we want requires a strong and dedicated company focused on nothing else. That in turn requires people work on it full time, the only way we can pay for that is to charge prices which will allow it. Michelle and I do not own a car, or a house, we have no savings or insurance, all our possessions fit in two back packs. We own and have next to nothing. No one here is even comfortably well off. So if you are pissed off about what we charge console yourself with the knowledge that we are broke.

For those of you saying to yourselves “if they cut the price people would buy more helminths and they would make way more money”, think again. This is not price elastic, that is total sales will not rise enough to compensate for any cut in price, in fact the opposite is true. This is price inelastic, we would make more money if we raised our prices, and we would work less, too. Most people do not base decisions on medical care on price, primarily. They are focused on quality of service, safety, efficacy and want a trustworthy provider. No one offering cut-price helminths would be able to offer the level of service and support we do. “Cheap blood sucking parasites over the internet from strangers available here! One time clearance sale, this week only!” I don’t think so.

Those who believe it should be a lot cheaper, I am often quoted prices of $50 or so as being reasonable, obviously have no understanding of what it takes to provide a product or service. All they see is the raw material cost, and having no experience running a business they have no idea about all the other factors that go into price.

I don’t believe this is the place to explain issues like fixed and variable costs, amortisation, marginal pricing, overhead, arbitrage, competitive vs. cost-based pricing, etc. Suffice to say the cost of real estate, marketing, insurance, equipment, materials and chemicals, marketing, sales, hosting, legal expenses, risk, profit, fees for hosting and credit card processing, and many others all go into price.

Nor do I believe that anyone is that interested in a detailed price comparison of helminthic therapy with competing therapies. But as an example Tysabri for MS costs about $140,000.00 over five years for the drug alone, never mind the blood tests and medical care also required. For the same period of time, safer and with better results for MS, you would pay $3,050.00 (2010) for hookworm from Autoimmune Therapies.

Nor is that comparison exceptional, it is the norm. You would pay about $55,000.00 for TSO over five years. Over ten times what we charge, and the only directly comparable therapy available.

By those measures our prices are very low.

Risk is another issue that affects price in any business. Think of various third-world agricultural commodities like Copra or Cocoa, Palm Oil, Coffee, now think of those third-word agricultural commodities that are not available from the corner store. A similar dynamic is at work here, and reasonably so given our flight from the US and our likely lifetime separation from our children.

Would you be willing to sell something cheaply that might result in your going to jail? Again, I would argue that on that basis our prices are very low.

Nor do we just sell helminths, a host of necessary services go into providing helminths, above and beyond dose preparation, particularly when one’s goal is more than turning a profit:

Information: before and after the sale, not just providing it but gathering it to improve what everyone wants, the rate at which people get better and the degree to which they when they respond. Formulating protocols to deal with every eventuality post infection. All of that takes a lot of time. Surveys, aggregating the results and trying to draw conclusions about what the information means. At some point in the future all that will be known and understood, and it will no longer be charged for.

Tailoring therapy to the individual: This is not a therapy where one dose fits all, it goes beyond balancing the desire for the biggest therapeutic impact on the first dose and avoiding unpleasant temporary side-effects from taking too many the first time. When someone buys therapy from us they are not just buying a single dose of helminths. They are buying that and the ability to add supplemental doses within the first year for just the cost of shipping, a 25% discount on supplemental organisms, reinfection for just the cost of shipping if they lose their infection, a 25% discount on then current prices when reinfection becomes necessary in five or so years when the first dose dies of old age, consideration and advice by us regarding our observations on the use of traditional therapies in conjunction with helminths, our experience reducing dependence on other drugs and how best to go about it, etc.

We promise everyone that we will do whatever is possible to make them well, and we do exactly that.

Discounts for those deserving: In the last week we decided to provide combination therapy for free to a sixty-plus year-old woman with primary progressive MS who is on social security. Those with the ability to pay full price are in effect paying for her therapy, and we have done this more than once.

Programs for unstudied diseases: before leave the US we provided therapy on a deferred payment basis to anyone with a disease, like Diabetes or Rheumatoid Arthritis, for which we had no experience and for which there is no science yet. Those with diseases we believe could respond were able to obtain therapy for just the cost of shipping. If after a year they decided it had not worked if they told us they had eliminated the helminths they owed us nothing. If they decided to keep them because they had benefited they owed us for therapy, with the option to pay over time.

We did this, and a successor program where therapy is discounted by almost 2/3, because we are working constantly to expand the amount of information on helminthic therapy’s potential, which we believe is enormous, and to add to the store of knowledge. We are able to do this because of the fees paid by those willing and able to do so.

Variability in the level of service required: Rather than charge for each of our services currently included in the cost of helminthic therapy: replacement of doses blocked or lost in shipping for free, reinfection for the cost of shipping regardless of the cause of the loss of helminths, stool tests to confirm infection because most western labs are incompetent to do the test, ongoing advice before and after treatment for as long as the client hosts the helminths, discounts on future purchases of any therapy we sell, access to a private forum, blog site and mailing list, setting up and managing this forum and various sites with information about this therapy and the issues surrounding it, we included those costs in the price of therapy.

We do this because response, what is required to get well, varies so much from person to person, and because people would be unwilling to pay for all these services individually, and because there is no practical way to cleave those services from the provision of the helminths in terms of pricing. This of course means that some people are paying for services they many never use. But many others are receiving services beyond that which they paid for, and if we did not roll all those services up in the price it would be too confusing to be able to sell, and less efficient.

People are not buying hookworm or whipworm from us, they are purchasing the chance to be well. There is far more to accomplishing that, and maintaining it once attained, than just shipping some hookworm or whipworm.

You can argue that you may not want or require those services, but we are not willing to abandon our goal of making this therapy accepted, or our goal of 100% response rates for all diseases we routinely treat. To do that we need to steer a course that is quite particular, and that requires us to behave as we do. If you don’t like that you have the option to obtain helminths independently of us.

Take one example of our experience and why we believe our approach is required: Debora Wade’s, who I feel comfortable discussing because she is so open about it and has documented it so extensively online. Debora purchased Multi-dose therapy from us when it did not exist. That is we created multi-dose therapy, where treatment with hookworm consists of 3 or more doses over time, at her request.

We planned on providing her 3 doses, but we priced it on the basis of two doses, that is we did not charge her 3x single dose therapy, we charged her 2x because we believed it was too expensive. Not that we did not feel it was justified, we were expecting to do three times the work. We ended up providing her with around ten doses at no additional charge. I also took risks at the time, which she had not paid for, to provide her with helminths at her home because the impact of travel on her health was so great.

After improving initially she lost her helminths after about six months, and because her side effect reaction had been so strong, and because we mis understood one another so badly and she did not trust me she was afraid to reinfect. I persisted, despite many differences between Debora and I, and at great cost to us in many ways, and was finally able to persuade her to reinfect bout fifteen months ago.

We spent so much time on Debora’s case, man-weeks or -months, that even though Debora paid almost $8K to us we probably ended up earning minimum wage or less.

The result is that Debora has reported to us in the latest survey that her response, in her own words, is a 4.0 out of a possible 5.0, where 5.0 is drug free remission (I asked DW’s permission to publish her survey result). Obviously this might change, for better or worse, as we do not have long term information.

Doing this for Debora required countless conversations and discussions with her and internally here. It required a great deal of thought, and argument, and research. Finding, downloading and reading and discussing dozens of scientific papers. The background was an often shrill and very public series of arguments between Debora and I.

A lot of sleepless nights thinking about it, worrying about her and how to make her well, about whether or not it would work. How much do you think a doctor would have charged for such a service?

I am certain that no other business or group of people would have persisted with Debora at such great cost in the way we did.

We did so because to be able to treat Crohn’s effectively we needed to learn how to treat Debora successfully. We learned things we use with every Crohn’s patient we have, things that have raised our success rate and improved the end result for many, when if we had just treated her as an opportunity to sell some helminths her case would have been a failure from which nothing would have been learned. if we just sold helminths as cheaply as possible as so many advocate I know this therapy would not be as advanced as it is, and it may have disappeared. The information we gather and provide is crucial to helminthic therapy’s development and success.

When people buy therapy from us they are getting the commitment that we will work tirelessly and do everything we reasonably can to help them get well. We are not just simply selling them a package of hookworms or whipworms.

Did Debora pay a lot of money? Yes. Did we make a lot of money off Debora? Not on an hourly basis, no. Was it worth it? Yes, if viewed from our point of view.

From Debora’s point of view? I have no idea. But I do know that after over twenty years and countless traditional drugs that Debora’s Crohn’s is doing very well for the first time in a long time, and thanks to hookworm alone.

We have done the same for others as for Debora many, many times. We will continue to do so.

Over time we have adapted our treatment protocols, added whipworm to deal with Ulcerative Colitis, and adapted our policies. At each step this has been to the benefit of our clients, and to our sometimes substantial cost.

Once we had obtained whipworm we offered them for just the cost of shipping to every one of our existing clients to that point, so that those who had not benefited from hookworm alone or who had only seen a partial result could have another shot at getting better.

Do you think other companies or people would have made that choice? Do you think that having failed with hookworm people would have been prepared to pony up for whipworm even if prices were lower? I don’t, and all those failures with hookworm we turned into successes with whipworm would not have happened, would not have become part of the public record if we just treated this as an opportunity to sell helminths at the lowest possible price. Helminthic therapy would not be as far advanced.

It is our policy that this process will repeated if we ever acquire other potentially beneficial organisms. This has resulted in some of our UC clients getting better when hookworm alone proved to be of no use for Ulcerative Colitis for just the cost of shipping to that group. They did not pay for this when they bought hookworm from us, and had no reasonable expectation that it or any other organisms would be offered in this way.

At some point helminthic therapy will be widely available, and the situation will have changed so that instead of being an experimental therapy regarded as lunacy by most it will be accepted as something obvious, as part of the medical landscape. When that happens the cost of therapy will no longer includes so many factors, like risk or the acquisition of knowledge or providing it to the client. Those services will be provided to you by your doctor, not by whatever company will be selling you helminths.

Which is something else to consider, pioneers like us do not profit from their efforts, it is those who follow. We have no expectation of getting rich, and if you are interested we are broke.

If anyone disagrees with us in terms of pricing or our policies they always have the option do obtain helminths independently of us and to start a business selling them, or, to give them away if that is their wish.

What they do not have the right to do is to criticise our prices when utterly ignorant of the factors that go into our pricing and without consideration of the services we provide surrounding the delivery of the helminths themselves.

Every time someone expresses an opinion here many people will read it. Many are not equipped to evaluate what they read here, they see opposing view points, worry that we don’t know what we are talking about or that we are crooks, and make the best decision they can based on the available information.

You may be raising a valid point, you may also be putting off dozens of people who are seriously sick who we could make better, and who may chose not proceed with helminthic therapy because you have posted something that frightens them that has no basis in fact.

If you sincerely disagree with our point of view, or believe that while it is valid there exists a place in the market for a company providing helminths without all the supporting services, you are welcome to do so.

Go to the tropics and risk violence and infection with diseases you don’t want.

Learn how to use a microscope, centrifuge and micropipette, and buy all of the above.

Buy and learn how to use the chemicals and antibiotics required.

Learn how to set up and administer a web site, databases, security, back-up and redundancy, and a business entity and associated bank accounts and ability to process credit cards suitable to do what is required.

Learn how to advise people on what dose to use, which organisms are appropriate for their disease, age, gender, etc.

Research and write various web sites to provide supporting information, create and manage an online forum or forums to create and support a community.

Accept the responsibility that goes with offering something like this when profoundly sick people, often at the end of their financial and physical ropes, are depending on you. When you are the last hope for someone facing surgery, death and bankruptcy, lie in bed at night considering every syllable of what you say to them.

Don’t forget about their spouses, parents and children who are in turn dependent on them, and therefore, on you.

Accept the risk, as we did in advance of it happening, that the FDA or similar may drive you away from your children, your home, the place you have lived your entire life.

Set up a travel bag with everything you will own if such a thing happens, and put a few thousand dollars in it so you can get to a safe place, remembering that everything you own will be contained in that bag and that that money will be all you have.

Remember that even calling your children could expose you to arrest.

In addition remember that you will be working in an environment that is very different from the one I saw when considering this. More research, more widely discussed and understood, many websites and blogs discussing this, news and media coverage. You will not have to sacrifice your career, mortgage your house, endure ridicule or doubt as I did, or impoverish your family, in an environment where there was very little evidence to support your ideas and beliefs. No one had seen their asthma go into remission before I started doing this, never mind their Crohn’s or MS, their Ulcerative Colitis or Sjogren’s. None of these things were known.

When you take that responsibility and do all those things, then, and only then, if you still disagree with our pricing you will have earned the right to debate us on the issue of pricing.

Recent test results for Jasper Lawrence

I am the primary reservoir for production of doses of hookworm and whipworm for AIT’s version of helminthic therapy, and recently there has been some speculation as to my current status re infection with Hepatitis, HIV, etc.

As you can see (you can download the test results here: “Jasper Test Results 10-2010.pdf”) I am negative for everything I was tested for. I had these tests in early October, 2010, they sent the letter at the end of the month. Being slow to post them was simply a matter of losing a letter in a move and then the holidays preventing my getting a replacement copy.

Although I think only a handful of people have ever asked me about such test results (in over three years of being in business providing hookworm and whipworm) those that do are very interested in the results. Perhaps others that are very interested don’t mention it for some reason? As I explain later, I am not sure such concern is appropriate.

Part of the delay posting these results was a desire to combine the Strongyloides results with those just posted in one post, but I have given up waiting for the letter. I have of course called multiple times about getting a copy but I am still waiting. We have also had a lot of problems with mail here for the last month because of the weather, so it is probable it was lost in transit. I will post it as soon as I get it, which will probably be tomorrow now I have relented and put these results up.

The only value in the test is to reassure people, falsely I would argue. Anyone preparing doses of this type for other people has to take steps as if the host is infected with everything, to do otherwise would be irresponsible.

The reasons for this are manifold.

First, you cannot test for every possible pathogen. I doubt I have enough blood for such a comprehensive panel, even if I had the money.

Secondly, a negative test result, unless the disease is an exotic, hard-to-encounter-unless-you-travel-to-some-weird place, organism like Strongyloides, cannot be entirely relied upon because most tests are for antibodies, not for the actual pathogen.

So there is inevitably a period of time, referred to as the Window, in someone recently infected who carries one of these diseases where they are not yet producing any, or sufficient, antibodies to show up on a test.

If you are at all familiar with the HIV test you already know this. The interval between exposure to HIV and being able to test positive is up to six months, and in rare cases say when there is coincident Hepatitis C exposure (or use of prophylactic therapy), even longer. Even if you are being tested monthly, or more frequently, for every human disease going, you still do not know whether or not you have picked up something since your last test, or if they are in the Window period.

Third, some diseases cannot be tested for, although the pathogen has been identified.

Fourth, some diseases clearly have an infectious component, but that vector or agent has yet to be identified.

So the results have no effect on dose preparation, and although it is reassuring to know that your reservoir is not a cesspool of human disease such reassurance is illusory.

What you should really be concerned about is whether the person preparing the dose has the requisite knowledge, skills and experience, and is caring and attentive each and every time they are in the lab.

After all if GlaxoSmithKine can screw it up in a multi-million dollar facility staffed with PhDs and highly trained technicians, who presumably were being inspected by the FDA periodically, then the most important factor has to be the professionalism and care of the person preparing the doses: http://business-ethics.com/2010/10/26/1740-glaxosmithkline-to-pay-750-million-fine-whistleblower-to-get-96-million/

Having said all that if it is important to you I am happy to submit to any test you desire, at any time, so long as you are willing to pay for it if you want me tested outside our normal schedule of once every two months, for the diseases given during organ donation.

Thanks,

Jasper