Please don't attempt TikTok's parasite cleanse

A squeamish trend has taken hold of wellness TikTok in recent months: the parasite cleanse. In the depths of this particular wormhole, TikTokers document their experiences taking papaya seeds or supplements like ParaGuard or Para-Vide to expel the parasites that have supposedly taken up residence in their intestines. At the end of their regimen, they present evidence of a successful cleanse in the form of a vivid description — or even a photo — of what they claim to be the critters in their poop.

“Most of us have parasites living inside us, and we don't even know it,” @musserwyatt explained in a TikTok documenting day one of his cleanse. Other TikTokers list a plethora of symptoms: constipation, dark under-eye circles, teeth grinding, depression, fatigue, and so on. @natalieclarehealing said her “anxiety dropped ten times” after passing a tapeworm. All of this makes intestinal parasites seem not only worrisome, but also super common. I mean, who hasn’t had constipation or anxiety? Could parasites actually be the culprit behind much of what ails us?

But amid all the testimonies about the tapeworms and liver flukes TikTokers have pooped out, I’m catching a strong whiff of wellness BS. The parasite cleanse trend seems to fall under a larger fixation with detoxing, or clearing our bodies of “impurities” to improve our health, which isn’t actually a thing. Sure enough, according to Kaveh Hajifathalian, an assistant professor and director of Advanced Endoscopy at Rutgers New Jersey Medical School, you most likely don’t need to do a parasite cleanse. Here’s why.

First of all, intestinal parasites aren’t as widespread as some TikTokers claim. While Hajifathalian tells me that microscopic, single-celled parasites called helminthes have a higher prevalence — more than 50% — in certain populations in the U.S., like those who don’t have access to good sanitation, the larger tapeworms and other parasites TikTokers report purging occur way less frequently. He estimates that they’re found in around 1 in 10 people in higher-risk groups, and only about 1 in 100 people in the general population. In fact, even if a doctor suspects that a patient with symptoms might have these larger parasites, once they actually check, they usually don’t find any.

In other words, if you’re not part of a high-risk group, don’t spend time in places teeming with parasites, or engage in activities like eating food that hasn’t been inspected for parasites, you probably don’t carry the larger worms TikTokers describe. While it’s not unheard for those who fall into this category to become infected with them, Hajifathalian says, “it’s not common by any stretch of the imagination.”

Even if you do belong to a high-risk group, evidence that the cleanses on TikTok can rid your body of parasites remains scant. Hajifathalian says people have probably gravitated to papaya seeds because of a 2007 study of 60 children in Nigeria — “a population that’s highly affected and at risk for these parasites” — randomly assigned to take dried papaya seeds and honey, or honey alone. After a week, the rate at which those who’d taken dried papaya seeds and honey cleared their stool of parasites was much higher than those who’d taken honey on its own.

But the study has some limitations. For instance, since none of the kids showed signs of infection — since it’s possible to harbor parasites without symptoms — Hajifathalian says we can’t yet conclude whether papaya seeds actually provide relief in people who do have symptoms. And “with just one small study, you basically do not know if what you’re seeing is a real effect or not,” he adds. While a 2014 study suggests that papaya seeds could remove parasites from goats, their biology differs enough from ours that it’s hard to say papaya seeds could do the same for us.

Not only might parasite cleansing supplements contain heavy metals or other extremely sus contaminants, “the expected benefit to you is, if not zero, very, very close to zero.”

Until researchers replicate the findings in larger human studies, we just don’t have strong enough evidence to recommend taking papaya seeds for parasites. That said, if you happen to enjoy papaya seeds, and you eat only a few at a time, they probably won’t harm you, Hajifathalian says. Eating too much could cause digestive issues, though.

The claims about so-called parasite cleansing supplements are even more dubious. Since the FDA doesn’t regulate supplements, they don’t need to meet the same requirements for safety and effectiveness that drugs do. So not only might parasite cleansing supplements contain heavy metals or other extremely sus contaminants, Hajifathalian says, “the expected benefit to you is, if not zero, very, very close to zero.”

Okay, but what about the, er, photographic evidence some TikTokers post of the parasites these remedies eliminated from their bodies? The thing is, if you haven’t been trained to examine stool, trying to assess it for parasites “is a little bit like a Rorschach test,” Hajifathalian says. What might pass for a parasite could just be food or mucus. That’s why doctors sometimes confirm the presence of parasites through non-visual methods like DNA sequencing or testing for antibodies the immune system makes against them.

Although it’s highly unlikely, if you think you have parasites, Hajifathalian suggests talking to your doctor instead of trying TikTok remedies. Symptoms of a parasite infestation, if you have them, can include anemia, abdominal pain, nausea, vomiting, blood in your stool, rashes, and itching. The symptoms TikTokers describe, like anxiety and teeth grinding, can indicate many other conditions that are more plausible than a parasite infestation, Hajifathalian says. For example, while teeth grinding can be a symptom of a small parasite more common in children, he estimates that not even 1 out of 100 people who grind their teeth have it.

“That’s one of the problems with these health trends,” Hajifathalian says. “Usually people advertise symptoms that are very common so that a larger number of the audience feels like they might be affected.” In the rare case that you test positive, your doctor will prescribe you potent antimicrobials, not papaya seeds or supplements.

The parasite cleanse trend is a classic case of the wellness industry creating a problem in order to sell us a solution. It comes as no surprise, for example, that @natalieclarehealing’s TikTok closes with a pitch for her parasite detox. Chances are, you won’t benefit from buying into the hype — but the supplement manufacturers certainly will.