Is Blasto Behind Your Hashimoto’s, Hives and IBS?

Rachel – thank you for following this page. The Epstein Barr virus creates a latent infection in the body, where it lies dormant until the right time, when it reactivates and awakens. The reactivated virus has the potential to induce the production of thyroid antibodies and has been implicated in many debilitating autoimmune symptoms.Testing for viral reactivation may be done through your doctor. You need to be sure to ask for the Epstein Barr Virus Early Antigen test, as this is a test that will let us know if the virus is actively replicating. I’ve found that many of these people, with a history of EBV in adulthood, also have the gut infection Blastocystis hominis, which has recently been connected to irritable bowel syndrome, hives AND Hashimoto’s. Interestingly, EBV is fueled by the amino acid arginine, while arginine depletion can cause Blastocystis hominis to be more pathogenic. In the last few years, I’ve noticed that getting rid of the Blastocystis hominis infection can help people to get their Hashimoto’s into remission. Read more about it in my Blastocystis article.

Is Blasto Behind Your Hashimoto’s, Hives and IBS?

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Blastocystis Hominis, H. Pylori, and Yeast Overgrowth

Note: A 2015 case study was submitted to a medical journal connecting Blastocystis hominis to Hashimoto’s! See reference #9 for the study. Here’s a link, so you can print it out and take it to your doctor.
When I first set out to figure out the root cause of my Hashimoto’s, I took an inventory of all of my symptoms to find an underlying connection. (I highly suggest that you make your health timeline to help guide you as well).
Here’s a brief overview of my health history:
  • My health troubles started during my freshman year in undergrad, after catching “mono,” a common viral infection that is caused by the Epstein-Barr virus. Prior to this infection, I was a bright-eyed, bushy-tailed and energetic young woman.
  • The summer before I started college, I would wake up at 5:30 am or 6 am each morning so that I could go to the gym, before starting work at 8 or 9 am in the pharmacy. I loved my job as a pharmacy technician, learning about the body and medications, and couldn’t wait to start my studies to become a pharmacist! I worked full time in the pharmacy and spent each evening studying for the pharmacy technician certification. I was proud to be the youngest person in Illinois to become a certified pharmacy technician, even before starting college. I loved learning and being out in the world!
  • But all of that changed during my second semester in college. I became chronically exhausted. I often slept through my morning classes, and sometimes even slept through lunch and dinner. I once even slept through a midterm exam. I found myself with a strange brain fog that made studying and even socializing a huge effort.
  • Needless to say, I didn’t do too well in college that semester. I came home the following summer feeling defeated. My parents were also really concerned as I was a shell of my former self. I slept until 2 pm each day, was moody, and lost so much weight; people suspected that I had an eating disorder.
  • After much rest, I got somewhat better at the end of the summer and went back to college. I focused all of my limited energy on my studies and was eventually able to improve my GPA to be accepted into a competitive doctor of pharmacy program. While I never returned to my previous levels of energy, I learned to how to be more efficient, how to compensate, and how to make sacrifices, which allowed me to succeed in all of my classes.
  • A few years later, while in my first year of pharmacy school, I developed irritable bowel syndrome. A few years after that, anxiety attacks, acid reflux, allergies, and hives. A year or so after, I began to experience acid brain fog, hair loss, and joint pain. The fatigue persisted. A year later, I was diagnosed with Hashimoto’s.
Once I had the diagnosis, I began to spend a lot of time on research, as well as self-reflection and self-experimentation, to overcome Hashimoto’s. My symptoms and research kept leading me back to the gut…
I learned that I not only had food sensitivities and a lack of beneficial bacteria, but I also had gut infections: small intestinal bacterial overgrowth, H. pylori, yeast overgrowth, and Blastocystis hominis.
I’ve found that people with Hashimoto’s and chronic hives often have the gut protozoan parasite Blastocystis hominis, and that eradicating the protozoa can resolve hives, IBS, and even Hashimoto’s. Scientists in Bosnia first published this connection in 2015, though I’ve seen it clinically since 2013.
Many improvements in symptoms and a reduction in antibodies can happen after addressing a Blastocystis hominis infection, and I’d like to share just how you can do that. In this article, I’ll cover:
  • What are the symptoms of a “Blasto” infection?
  • The connection between Blastocystis and hives
  • Can Blastocystis cause IBS and gut issues?
  • Treatments that can address this infection
  • Common co-occurring infections

The Hashimoto’s, Hives, IBS and Blastocystis Connection

Did you know? People with Hashimoto’s are more likely to develop the skin condition chronic spontaneous urticaria, also known as chronic hives, which is manifested by widespread, itchy and swollen skin rashes. These hives can be very distressing, and they can seem to come up randomly. 42 scientific studies have linked Hashimoto’s with chronic hives!
People with Hashimoto’s are also more likely to develop irritable bowel syndrome (IBS), a chronic condition that affects the large intestine and often shows up before one’s Hashimoto’s diagnosis. This condition can manifest as either diarrhea or constipation, or both, and may also cause excess gas, bloating, abdominal pain, and cramping that is often relieved after passing a bowel movement.
By far, the most common parasite I’ve found in people with Hashimoto’s is Blastocystis hominis, or “Blasto”, and it can contribute to both conditions mentioned above.
Many conventional physicians have regarded this parasite as a commensal organism (up to 20 percent of “healthy controls” may have Blasto without any symptoms), and will say that there is no need to treat it. However, multiple studies have found it to be implicated in irritable bowel syndrome (IBS) and chronic urticaria (hives), two conditions that are very commonly associated with Hashimoto’s.
Symptoms of Blastocystis hominis can include bloating, diarrhea, nausea, flatulence, variable bowel habits, abdominal pain, hives, and fatigue. Additionally, this pathogen is notorious for causing multiple food sensitivities. A true food sensitivity, like celiac disease, usually results in a resolution of symptoms once food is removed, but Blastocystis hominis-infected people will have multiple food sensitivities and will keep getting more.
In 2015, 35 percent of my clients tested positive for it. I have found this parasite in a large subset of my clients with Hashimoto’s, especially in those who develop Epstein-Barr Virus (EBV) in adulthood, then are “never quite the same.” This could be because EBV and other herpes viruses feed on the amino acid arginine, and thus can cause a depletion of this amino acid which normally suppresses Blastocystis hominis.

The Blastocystis and Hives Connection

Blastocystis hominis is a common human intestinal parasite, and it may be present in up to 50 percent of people in developing countries. A study of 54 people in Egypt with chronic urticaria (hives) revealed that Blastocystis hominis was found in 61 percent of them, while only 8 percent of the healthy controls had the parasite.
This parasite has been found in some asymptomatic carriers, and researchers hypothesize that other factors can influence the pathogenicity of this parasite, such as the immune status of the host, parasite load, presence of gut imbalance or other factors that can influence the behavior of parasites.
Researchers have suggested that the amoeboid form of Blastocystis hominis is more infective that the protozoa form and that it can adhere better to gut cells. Interestingly, the Egyptian study found this form in 60.6 percent of the Blastocystis infected people with hives, while none of the Blastocystis infected controls had this form.
In a letter to the editors of the British Journal of Dermatology, Dr. Tilo Biedermann from the Ludwig-Maximillians University in Munich, Germany reported that urticaria and reactions to NSAIDs subsided after treating 10 subjects infected with Blastocystis with paromomycin 25 mg/kg for 10 days.
Another drug, called Alinia (nitazoxanide), is an FDA-approved antiprotozoal for treating other parasites, and has been helpful in eradicating Blastocystis hominis. The parasite has been shown to be highly resistant to Flagyl (metronidazole), the usual drug of choice.
A 2014 study found that almost 25 percent of people with chronic urticaria had Hashimoto’s, and thyroid suppression by levothyroxine can result in a clinical remission of hives. However, I wonder if the medication is just masking the symptoms of the parasite.

The Blastocystis and Gut Connection

Various studies, using many different methods for parasite identification, have found the prevalence rate of Blastocystis hominis to be between 13 to 73 percent of people with irritable bowel syndrome. As parasite detection methods are not 100 percent reliable (with many false negatives), these rates could be even higher.
Blasto has been shown to cause dysbiosis and leaky gut, which predisposes us to autoimmunity!
Much controversy is out about this protozoan. Some studies, namely from Thailand and Mexico, suggest that this is a commensal (harmless) organism. Thus, doctors may be told that there is no need to treat it. However, studies from Europe, Australia, and the mid-east have connected this pathogen to not just chronic hives, but also irritable bowel syndrome, both of which are very common manifestations in the early stages of Hashimoto’s.
Studies have found that Blastocystis species of protozoa do not invade the colonic mucosa, but they do lead to disturbances of the barrier function and increased intestinal permeability. Thus, Blastocystis has been shown to cause leaky gut. Blastocystis breaks down secretory IgA, the protective barrier and the immune system of its infected host.
Research has found that eradicating Blastocystis in urticaria and IBS often leads to the remission of both conditions. I’ve found that eradicating a Blastocystis infection in a person with Hashimoto’s often leads to a remission of Hashimoto’s, with an improvement in symptoms, a reduction in food sensitivities, and a reduction in thyroid antibodies. Eradicating this infection has also helped many of my clients reduce their joint pain, eliminate or reduce their IBS symptoms, and reduce their fatigue. I was super excited to learn that a new paper has been published in a medical journal, detailing the case of a person who saw a reduction in TSH and thyroid antibodies after the eradication of Blastocystis hominis.

Testing for Blasto

If you suspect you may have a Blasto infection, you may want to consider ordering a non-invasive functional medicine stool test. Tests that check for this infection include:
  • GI-MAP – This panel includes bacteria, viruses, opportunistic organisms, normal flora, parasites, and fungi. The DNA/PCR techniques that are employed by this assessment also measure one’s antibiotic resistance genes and virulence factors that contribute to pathogenicity.
  • GI Pathogen Screen with H. pylori Antigen – This panel screens for ova, parasites, bacteria, fungi, yeasts, and occult blood. It also checks for antigens to Helicobacter pylori, Entamoeba histolytica, Cryptosporidium parvum, and more.
  • GI Effects Comprehensive Profile – This panel from Genova Diagnostics uses DNA analysis to go beyond the standard parameters for identifying gastrointestinal disorders.
  • Comprehensive Stool Analysis (Doctor’s Data Kit) – The Comprehensive Stool Analysis evaluates the status of beneficial and imbalanced commensal bacteria, pathogenic bacteria, fungi, and yeast.

Treatment Options

According to the Blastocystis Research Foundation, “Some patients can manage symptoms with an extensive exclusion diet, which may include the exclusion of refined sugar, wheat, dairy products, rice, corn, carbonated drinks, tea, coffee, alcohol, and fruit.” Blastocystis can also cause carbohydrate intolerance. Sound familiar?
While diet can help to manage symptoms, it will not eradicate the pathogen. This parasite needs to be treated with antiprotozoal medications and/or herbs.
I have seen the following protocols for eradicating Blastocystis hominis to work effectively:

Medications

1) Triple therapy used in Australia: diloxanide furoate, trimethoprim/sulfamethoxazole and secnidazole*
OR
2) Alinia for three days on, then off for two weeks, repeated twice*
*Keep in mind that antiprotozoal medications can lead to a yeast overgrowth, and treatment with anti-yeast herbs or a medication like Nystatin may be necessary to rebalance the gut.

Natural Treatment Options

3) The beneficial yeast Saccharomyces boulardii, taken twice per day for at least 30 days
4) The use of antiparasitic/anti-yeast herbs such as oil of oregano and berberine.

Tips

The key is to use these treatments long enough, or in a pulsed fashion, to fully eradicate Blasto. Blasto can take on four different forms during its lifecycle and some of the forms are resistant to treatment.

Removing food sensitivities and getting probiotics on board will also be very helpful for recovering from Blasto.

Co-occurring Infections to Consider

Often, Blastocystis co-occurs with H. pylori, another potential root cause and trigger of Hashimoto’s. Some professionals will go as far as to treat a person for both infections when one or the other is found. You can read more about H. pylori in my article here.

Next Steps

Addressing infections can make a dramatic difference on your health journey. However, some people may need to dig further and address their other root causes of their remaining symptoms. I always talk about how switching my diet was the best thing I ever did. It was my first step into the root cause approach to health. I went gluten and dairy free, and this lifestyle change completely eliminated my acid reflux, bloating and irritable bowel syndrome. Within 3 months, I no longer had symptoms of carpal tunnel and saw a reduction in my thyroid antibodies as well! You can read my articles about Hashimoto’s and acid reflux and Hashimoto’s and dairy.
Some people with Hashimoto’s can completely reverse their condition just by going gluten and dairy free, and some see no improvement at all. Gluten and dairy are common leaky gut triggers, but there are many others.
I cover steps on how to search for your root causes, as well as a Blastocystis hominis protocol, in my new book, Hashimoto’s Protocol.
I hope this information helps you on your journey!
P.S. Be sure to sign up to my email list to get a free book chapter, recipes, Thyroid Diet start guide and notifications about upcoming events and my weekly newsletter.

References

  1. Sugiyama A, Nishie H, Takeuchi S, Yoshinari M, Furue M. Hashimoto’s disease is a frequent comorbidity and an exacerbating factor of chronic spontaneous urticaria. Allergologia et Immunopathologia. 2015;43(3):249-253. doi:10.1016/j.aller.2014.02.007.
  2. Zuel-Fakkar N, Abdel Hameed D, Hassanin O. Study of Blastocystis hominis isolates in urticaria: a case-control study. Clinical and Experimental Dermatology. 2011;36(8):908-910. doi:10.1111/j.1365-2230.2011.04127.x.
  3. Diagnosis | Blastocystis Research Foundation. Blastocystis Research Foundation. http://www.bhomcenter.org/info/diagnosis.htm. Accessed June 30, 2017.
  4. Nagel R, Bielefeldt-Ohmann H, Traub R. Clinical pilot study: efficacy of triple antibiotic therapy in Blastocystis positive irritable bowel syndrome patients. Gut Pathogens. 2014;6:34. doi:10.1186/s13099-014-0034-0.
  5. Poirier P, Wawrzyniak I, Vivarès C, Delbac F, El Alaoui H. New Insights into Blastocystis spp.: A Potential Link with Irritable Bowel Syndrome. PLoS Pathogens. 2012;8(3):e1002545. doi:10.1371/journal.ppat.1002545.
  6. Biedermann T, Hartmann K, Przybilla B. Hypersensitivity to non-steroidal anti-inflammatory drugs and chronic urticaria cured by treatment of Blastocystis hominis infection. British Journal of Dermatology. 2002;146(6):1113-1114. doi:10.1046/j.1365-2133.2002.473212.x.
  7. Dinleyici E, Eren M, Dogan N, Reyhanioglu S, Yargic Z, Vandenplas Y. Clinical efficacy of Saccharomyces boulardii or metronidazole in symptomatic children with Blastocystis hominis infection. Parasitology Research. 2010;108(3):541-545. doi:10.1007/s00436-010-2095-4.
  8. Levy Y. Chronic urticaria: association with thyroid autoimmunity. Archives of Disease in Childhood. 2003;88(6):517-519. doi:10.1136/adc.88.6.517.
  9. Rajič B, Arapović J, Raguž K, Bošković M, Babić S, Maslać S. Eradication of Blastocystis hominis prevents the development of symptomatic Hashimoto’s thyroiditis: a case report. The Journal of Infection in Developing Countries. 2015;9(07). doi:10.3855/jidc.4851.
  10. Irritable Bowel Syndrome. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016. Updated March 17, 2018. Accessed April 30, 2018.
Note: Originally published in September 2015, this article has been revised and updated for accuracy and thoroughness.