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SCIENCE

Hookworm therapy cures insulin resistance but faces FDA blockade

Thursday, May 21, 2026 · from 4 podcasts
Peter Attia DriveSimon Dixon Hard TalkRadiolabThe Joe Rogan Experience
  • Live hookworms reverse insulin resistance and lower blood glucose in clinical trials.
  • The FDA refuses to regulate living organisms, forcing therapy underground.
  • Researchers aim to isolate worm proteins for a synthetic pharmaceutical alternative.

A clinical trial using live hookworms as therapy delivered results pharmaceutical executives can’t replicate. In an Australian study led by Dr. Paul Jackerman, pre-diabetic patients infected with the parasites saw significant reductions in blood glucose and insulin resistance, with some effectively cured. Most participants opted to keep their worms after the trial concluded, citing improved metabolic health and unexpected boosts in mood and sleep quality, as reported on Radiolab.

"Participants saw decreased blood glucose and weight loss, while the placebo group continued to decline. Some patients were effectively cured of their pre-diabetic status during the trial."

- Radiolab

The mechanism is a biological hack. Hookworms secrete proteins to calm the human immune system, ensuring their own survival. This action, researchers theorize, inadvertently treats the inflammatory underpinnings of modern autoimmune and metabolic diseases. Dr. Paul Jackerman argues on Radiolab that by eradicating hookworms a century ago, we deleted a co-evolved immune regulator, trading historical lethargy for today’s epidemics of asthma, allergies, and Crohn’s.

The therapy faces an intractable regulatory wall. The FDA’s approval pathways are built for standardized chemical compounds, not living organisms cultivated in human hosts. Jasper Lawrence once ran a business mailing hookworms to patients before being forced overseas by regulators. The logistical hurdle is fundamental: you can’t easily culture hookworms in a lab, requiring human "worm farms" for production.

This impasse has split the field. One path leads to a thriving black market for self-infection. The other, pursued by researchers, aims to identify and synthetically manufacture the specific calming proteins the worms secrete. Until a pill is developed, a treatment with compelling clinical data remains trapped outside the medical establishment, a casualty of regulatory design.

"The transition from 'poop to pill' is a logistical nightmare. You cannot easily culture hookworms in a lab; you need human 'worm farms' to produce the larvae."

- Radiolab

The resistance highlights a broader tension in medicine, echoed in other podcast discussions. On The Peter Attia Drive, the host argues that for most chronic diseases, measuring the phenotype - actual biological outputs like blood glucose - is more actionable than genetic predictions. Similarly, hookworm therapy represents a direct biological intervention, bypassing complex genetic and pharmaceutical intermediaries for a blunt, effective tool the system refuses to assimilate.

#Health#Regulation

Source Intelligence

- Deep dive into what was said in the episodes

The Peter Attia Drive
The Peter Attia Drive

#392 - Genetic testing: when it's valuable, how to choose the right test, and what to do with the results • May 18

  • Peter Attia says genetic testing is often oversold; the core question is not 'should I test' but what specific health question a test could answer and whether genetics is the best tool.
  • Peter Attia argues the Human Genome Project, completed in 2003, failed to deliver on broad promises of predicting complex diseases. He notes the genome's complexity: 20,000 genes, 6 billion base pairs, and 5 million single nucleotide variants.
  • Attia states most genetic risks are probabilistic, not deterministic. High-penetrance mutations like Huntington's disease are the exception. Most common diseases involve many genes layered on environment, behavior, and chance.
  • Peter Attia lists four limitations of genetic testing: genetic data are often probabilistic; our ability to interpret lags data generation; phenotype measurement is often more informative; and results can carry psychological weight.
  • Attia says for atherosclerotic cardiovascular and metabolic disease, routine genetic testing is weak. He argues measuring phenotypes like blood pressure, lipids, and insulin resistance is more actionable than genetic estimates.
  • Peter Attia cites exceptions in cardiometabolic disease: familial hypercholesterolemia for confirming diagnosis, SCARB1 mutations that mask cardiovascular risk on a standard lipid panel, and cases where genetic data shifts patient behavior.
  • Attia says only about 5% of cancers are attributable to inherited germline mutations. He notes hereditary cancer panels for high-penetrance genes like BRCA1/2 and Lynch syndrome are highly actionable, changing screening and management.
  • Peter Attia warns consumer genetic tests often assess only a few pathogenic mutations; a negative BRCA result on 23andMe does not rule out thousands of other known pathogenic variants. Clinical-grade panel testing is needed for risk assessment.
  • Peter Attia says APOE4 is the strongest common genetic risk factor for Alzheimer's, with homozygotes having up to 15 times higher risk. He notes it is not deterministic, with about 50% of Alzheimer's patients not carrying an APOE4 allele.
  • Attia is skeptical of functional medicine panels like MTHFR testing. He notes up to 40% of the population carries these common variants, and they rarely drive meaningful disease or justify specialized supplement protocols.
  • Peter Attia highlights pharmacogenetics as a genuinely useful area. Examples include CYP2C19 testing for Plavix activation, where 10% of people cannot convert it, and HLA-B*58 testing to avoid life-threatening reactions to allopurinol.
  • Attia ranks test utility on two axes: effect size of the variant and clinical actionability. Hereditary cancer panels and pharmacogenetics score high, while consumer SNP tests for MTHFR score low on both dimensions.
  • Peter Attia categorizes genetic tests from narrowest to broadest: single-gene tests, genotyping arrays (SNP tests), gene panels, whole exome sequencing, and whole genome sequencing. He advises matching the test type to the specific clinical question.
  • Attia recommends using CLIA-certified labs with domain expertise for clinically meaningful tests. He stresses understanding a test's coverage, privacy policies, and the meaning of a negative result before ordering.
  • Peter Attia frames the value of a genetic result around the question 'what now?'. He says results should either confirm a diagnosis, identify a novel actionable risk, add context, or inform planning - otherwise the test lacked purpose.
#Longevity#Biology
Simon Dixon Hard Talk
Simon Dixon Hard Talk

Silicon Valley Meets the CCP: What the Shanghai Summit Tells Us About the AI Arms Race • May 15

  • Dixon claims Trump's trade policy led to record US small business bankruptcies, with 95% of tariff costs paid by them, while large multinationals offset costs via international production.
Also from this episode: (6)

Trade (2)

  • The Shanghai summit between US corporate elites and the CCP formalized economic ties to facilitate a managed transition to a multipolar world order, with the AI and robotics buildout as the central industrial project.
  • The White House announced China would resume buying US oil and LNG, which Dixon frames as a low-value, face-saving concession that merely returns trade to its pre-2025 status quo before China halted purchases.

Markets (1)

  • Simon Dixon argues the US bond market shows severe stress, with the 30-year Treasury yield printing above 5% and the 10-year yield over 4.5%, which translates to 7% mortgage rates and a seized-up real estate market.

Inflation (1)

  • Dixon states US CPI registered at 3.8%, but he argues real inflation is far higher, citing a 77% increase in US beef prices since January as one example.

Business (1)

  • A key structural vulnerability Dixon identifies is the West's derivatives market for commodities, where paper contracts vastly exceed physical holdings, while China acquires physical gold without such overhang.

AI & Tech (1)

  • Dixon argues the AI arms race narrative justifies the enormous fiscal spending needed to bail out the financial system, with the AI data center buildout consuming vast energy and driving stock market concentration.
#AI Infrastructure#Big Tech#Macro#China#Energy
Radiolab
Radiolab

Your Friendly Neighborhood Hookworms • May 15

  • John D. Rockefeller launched a commission in 1908 to investigate Southern economic stagnation, which attributed it to a laziness disease.
  • Rockefeller's investigators later linked anemia in the South to sandy loam soils and discovered hookworm infections were the cause.
  • Researchers built a sandbox experiment showing hookworm larvae could crawl four feet from infected stool, leading to the adoption of outhouses dug six feet deep.
  • Dixon Despommier argues improved sanitation and outhouses eradicated hookworm and also reduced diseases like salmonella, cholera, and giardia.
  • Jasper Lawrence discovered research showing asthma was 50% less likely in people with hookworm infections, leading him to seek infection in Cameroon.
  • Lawrence infected himself by walking barefoot in 30-40 village latrines and reported his allergies and asthma disappeared completely afterward.
  • Lawrence later started a business selling hookworms to about 85 clients, sourcing them from his own stool, despite lacking FDA approval.
  • David Pritchard's safety study found 10 hookworms were tolerated, but 50 worms caused gut pain and potential anemia from blood loss.
  • Paul Giacomin's research uses worm farms where volunteers host hookworms to produce eggs for clinical trials, delivered via bandages on skin.
  • Hookworm larvae enter through skin, travel via lymphatics and bloodstream to the lungs, are coughed up and swallowed, maturing over two to three weeks before settling in the small intestine.
  • Adult hookworms bite the intestinal wall to feed on blood, initially causing inflammation and diarrhea, then release proteins that promote wound healing and quiet the immune system.
  • Giacomin's two-year trial on pre-diabetic patients showed hookworm treatment reduced blood glucose and insulin resistance, with some patients no longer pre-diabetic.
  • Almost all participants in Giacomin's trial opted to keep their worms after the study, and placebo-controlled trials for celiac disease reported improved well-being, mood, and sleep quality.
  • Research links hookworms to potential benefits for multiple sclerosis, ulcerative colitis, and Crohn's disease, with some patients entering remission.
  • The hygiene hypothesis posits that eliminating parasites like hookworms through improved sanitation may contribute to increased autoimmune disorders.
  • Current hurdles for hookworm therapy include sourcing from stool, standardization challenges, and public aversion, leading researchers like Giacomin to pursue developing isolated worm proteins in pill form.
#Health#Longevity#Biology#Regulation
The Joe Rogan Experience
The Joe Rogan Experience

#2499 - Marcus King • May 14

  • Marcus King found Ozempic curbed his desire for alcohol but caused severe stomach cramps, while Joe Rogan cites side effects like pancreatitis and eye stroke.
  • Joe Rogan advocates discipline over drugs like Ozempic, citing Jelly Roll's 300-pound weight loss through daily running and exercise as a superior model.
  • Joe Rogan argues cannabis should be federally legal and regulated like alcohol, generating tax revenue and ending cartel cultivation on public lands.
Also from this episode: (13)

Society (4)

  • Marcus King struggled with alcohol due to a destructive quality that emerged when drinking, leading to blackouts and strained relationships.
  • Joe Rogan quit drinking for eight months to break a cycle of nightly drinking at the club that left him feeling perpetually drained and impacting his workouts.
  • Marcus King views live performance as a channel for anxiety, shifting from seeking audience approval to aiming to share love and create a collective good time.
  • Joe Rogan states roughly half of US murders go unsolved, citing a statistic of 40-50% of homicide cases without arrest or resolution.

Culture (2)

  • Joe Rogan argues rock music lacks new major bands like Van Halen or ACDC, noting current popular rock often blends southern and country influences.
  • Marcus King cites Led Zeppelin as a jam band, framing his own shows around reaching improvisational sections guided by crowd chemistry.

History (2)

  • Joe Rogan discovered antique 17th century pirate flintlock pistols sell for around $400, questioning their low value given historical significance.
  • Joe Rogan explains the 1970 Controlled Substances Act targeted civil rights and anti-war movements, not science, trapping society under flawed laws for 56 years.

War (2)

  • Joe Rogan condemns Palantir's call to reintroduce military conscription, arguing tech executives advocating for war should experience combat firsthand.
  • Joe Rogan states no US war since World War II has made logical sense, framing forced military service as throwing children into unnecessary conflicts.

Psychology (3)

  • Marcus King attributes his weight to childhood psychological control and scarcity mindset, now managing it through a keto diet that avoids bread.
  • Marcus King says antidepressants numbed him emotionally, missing grief at his grandmother's funeral, and fears withdrawal and losing creative drive if he stops.
  • Joe Rogan argues the serotonin imbalance theory for depression is outdated, noting exercise is more effective than SSRIs and doctors are financially incentivized to prescribe.
#War#Health#Longevity#Macro#Society

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