Tik Tok is a cesspool of wellness pseudoscience and misinformation. All of social media has the potential to spread misinformation without any filter, but for some reason Tik Tok has become the preferred platform for the most outrageous claims and nonsense.
A recent trend on Tik Tok (and within the wellness community generally) is the parasite cleanse. The idea is that many people are walking around with GI parasites and don’t know it, and so a regular parasite cleanse should be part of a healthy routine. These claims are false and potentially dangerous.
Parasites are organisms that live on or inside other organisms as part of their lifecycle. They can exist chronically without causing an acute infection. Gastrointestinal parasites, like worms, can cause gas, diarrhea, bloating, stomach pains, fatigue and weight loss. Of course, a lot of other things can cause these symptoms as well.
This creates a perfect setup for a typical wellness scam – scare people into thinking they may have some otherwise rare or fake illness, then sell them a snake oil treatment for said illness. It’s best (for cash flow) if the treatment has to be done on a routine basis indefinitely.
While parasitic infections are a real thing, they are extremely rare in industrialized nations. We have the privilege of being able to easily prevent such infections – don’t eat raw or undercooked meat, and don’t drink “raw” water or untreated water. That’s pretty much it, and it’s really easy if you live in the US. Traveling to parts of the world where parasites are endemic and with poor hygiene is the main risk factor for people living in developed nations for getting parasites. It’s also possible if you eat food you hunted without preparing it or inspecting it properly, or if you camp and drink untreated spring water.
For most people it is not something you have to worry about. In the rare event that you may somehow contract a parasite, this is a serious medical condition and requires real medical treatment with medication. A “cleanse” won’t be enough if you actually have a parasite. See your medical doctor.
Here is just one example from Tik Tok – fearmongering over a case where someone had parasite eggs in their brain presenting as a “migraine”. First, anyone with a new headache is likely to get imaging, which can easily make the diagnosis, as it did in this case. Treatment with actual medicine is then required.
But the Tik Tok producer uses this case to claim that everyone should do a parasite cleanse multiple times a year. That would not have helped or prevented the parasite infection in this case. The parasite cleanses that are out there are generally not effective. Some include simple dietary restrictions, which may be benign, but can risk poor nutrition in extreme cases. In the case of an actual GI parasite, which includes weight loss as a symptoms, dietary restrictions may exacerbate the weight loss resulting in worse outcomes. The idea is to “starve the parasite” but that would not prevent or eliminate a parasite infection.
There are also many herbal concoctions promoted as parasite cleanses, with the most common ingredient being wormwood, which contains artemisia. Artemisia does have some anti-parasitic (helminthic specifically) activity, but when given as an herb suffers all the limitations of this approach. As this study demonstrates, for example, in vitro effects do not always translate in vivo. This means that because an herb or derivative kills parasites in a Petri dish, that does not mean it will have any such effect when taken orally. There are issues with bioavailability, half-life, and distribution, for example.
Further, there are over 500 species of wormwood, with highly variable amounts of specific constituents, which can also vary considerably by season, part, method of collection and preparation. This is a problem generally with herbal products, there is no consistency. If you have an actual parasitic infection, then you want to take a purified drug with known properties and amounts in a dose proven to be safe and effective.
Some herbal parasite cleanses also cause diarrhea, which is meant to create the impression that they are working. But this can be a dangerous side effect. Also, again, if you had an actual GI parasite, taking a drug that causes diarrhea would be counterproductive.
Artemisia in wormwood has also been shown to cause liver toxicity. Remember – herbal products are drugs, they are just poorly regulated drugs. They can have all the common toxicity and interactions that pharmaceuticals have, and liver toxicity is very common.
Good medicine is all about carefully considering risks vs benefit. The potential benefit of a routine parasite cleanse is negligible, because the risk of actually having a parasite for those living in developed nations is incredibly low. You are far better just not engaging in risky activity. The parasite cleanses out there also have unproven efficacy, with good reason to think that they are likely ineffective. They also carry some risk of direct harm through toxicity.
There is also the potential of indirect harm, through generating a false sense of security, delaying proper medical care, or diverting people from a proper medical evaluation.
A good rule of thumb is not to listen to wellness influencers on Tik Tok – which has risk massively in excess of any potential benefit.