I have always understood that autoimmune diseases, like inflammatory bowel disease, are genetic disorders that are set off by an environmental trigger. And I have always thought that for me this environmental trigger was when I got very bad salmonella poisoning in my first year of university. That in combination with my extremely poor diet, high alcohol consumption, and the stress of living on my own for the first time allowed the chronic disease to flourish in my body.
And suddenly I had Crohn’s disease.Me July 2023 just after having surgery to remove another abscess
I started helminths about 2 weeks later
But now, since repopulating my gut biome with helminths, I see this story through a slightly different light.
Our body is made up of millions of different living species. Humans did not develop as a single species, but rather as a ‘superorganism’, an ecosystem that contains millions of bacterias, yeasts, parasites, helminths, and other organisms we have not yet been identified.
Some of our microbes we get from our mothers as we exit the vaginal canal during birth. She gives us a mix of her microbes that form the base of our own microbiome.
But much of our gut biome is actually the result of our unique interactions that we have throughout the course of our lifetime. And the human biome is not only made up of permanent residents, but also species that interact transiently as they pass through.
Our unique biomes are determined by things like whether we have ever walked barefoot, ate dirt, touched animals, touched poop, swam in the seas, interacted with other humans, or spent our lives sitting inside a sanitized home; all of these factors continually create our biomes.
Pretty much any living thing that we touch is covered in microscopic creatures, and our interaction with these creates our own unique biomes. So that no two people on earth have the exact same gut biome.
It has been consistently shown in gnotobiotic (microbe free) animals that when mammals do not have microbes, the immune system remains underdeveloped.
Just like any muscle in the body needs to be worked to be healthy, your immune system needs to interact with the complex organisms that cover our planet, and have coevolved inside the human body.
We seem to forget that only 2-3 short generations ago indoor toilets were not commonplace. And modern medicine is just that: it is very modern. And the combination of these two things have basically eradicated helminth infection.
As humans become increasingly more sanitized, our biomes are becoming less diverse. This is biome depletion theory.
Biome depletion is happening at alarming rates, and will have far reaching consquences. In highly developed countries, with high levels of santizations, most people are missing an entire species from our gut biomes: helminths. This because helminths come from interacting with the natural environment, which we either do not do, or when we do the soil no longer contains these species. With the increased use of indoor toilets, sanitized foods and water, and the increased use of medications, helminths have been almost eradicated from the modern world.
Terrifying to think we have almost wiped out an entire species of our microbes, and most of us do not even know that helminths exist. Or the important role they play with our immune system.
Of course the rise of global ‘cleanliness’ does have its benefits. That is indeed why it has evolved. Sanitization does reduce the risk of many pandemics and various infectious diseases. But we becoming so clean (e.g. striped of all living organisms) that our water, soil, and food, which used to contain living organisms. Are now almost completely devoid of anything living.
And we have to ask ourselves, at what point have we gone too far? Like anything in life with benefits there are also drawbacks, and we must find a balance where we can avoid easily avoidable diseases, but also prevent the onset of autoimmune diseases.
We as a society have become so clean that many of us no longer have helminths in our bodies. And it has been shown over and over again that as rates of helminth infection decrease, we become more susceptible to autoimmune disease.
The good news is that we do not have to wait for society as a whole to change, or even lose the benefits of modernization. It has been widely found that repopulating the human ecosystem with helminths long term can reduce the risk and symptoms of autoimmune diseases.
That is because helminths secrete a complex mixture of chemicals that quiet and dampen the immune system’s response. This reduces levels of chronic inflammation, and makes the human body a better place for the worms to live.
Humans and helminths have a symbiotic relationship. And the potential complexity of the effects of losing entire species from our biomes is staggering. And something we cannot even begin to fully understand yet.
The decrease in biome diversity may be the environmental trigger that sets off not only Crohn’s and Ulcerative Colitis, but most autoimmune diseases including autism, MS, asthma, and allergies.
This can be seen globally as a country becomes more modern, its rates of autoimmune disease also rise. Many in depth examples of this can be found in the book The Epidemic of Absence.
It could also explain why the salmonella infection I got in first year allowed Crohn’s disease to develop in my body. Assuming I do contain the genetic trigger for IBD, then I deplete my already depleted biome further with poor lifestyle choices (I ate McDonalds, Kraft Dinner, and Cup Noodles for most of my meals). Without a prebiotic rich diet, my good microbes die off. And bad bacterias can take up valuable real estate.
Then I get a huge influx of salmonella bacteria. And with few good microbes taking up space, the salmonella can really take hold.
And because I did not have helminths in my body at this time, I had nothing to keep the inflammation caused by the salmonella in check. The bad bacterias flourished, inflammation became chronic, and my body developed Crohn’s disease that became more and more severe as time passed.
I have spent a lot of time thinking about how different my life might have been if I had a diverse gut biome that contained a wide range of species including helminths back then. Would the salmonella infection have been able to cause this chain reaction that eventually led to Crohn’s disease?
Probably not, as it has been found that childhood exposure to helminths can contribute to protection from immune related disorders later in life.
Remember when our parents used to say, let the kids eat dirt, it’s good for them! Or get them a dog it will help them with allergies later!
Turns out these old expressions are exactly what biome depletion is all about. Exposing ourselves to a variety of microbes throughout our lifetime to increase biome diversity and decrease our chances of autoimmune disease.
And when we cannot interact with nature in that way due to cultural limitations (living in a city; soils being too depleted), or we have already developed autoimmune disease; there is still hope.
We can repopulate the gut biome with domesticated helminths to reduce immune related symptoms, improve our quality of life, and take responsibility for our own health.