Are the estrogenic hormonal effects of environmental toxins affecting small intestinal bacterial and microfilaria overgrowth?

Med Hypotheses. 2017 Nov:109:90-94. doi: 10.1016/j.mehy.2017.09.022. Epub 2017 Sep 28.


The important role of microfilaria (worms) in human and animal disease remains an area of key disagreement between the naturopathic and allopathic physicians. While microfilaria infections are rampart in undeveloped countries, they rarely rise to identification as a cause of disease in Western countries. New research studies in the diagnosis and treatment of SIBO (Small Intestinal Bacterial Overgrowth) and (IBD) Inflammatory Bowel Diseases of ulcerative colitis, Crohn's Disease and microcytic colitis may make both sides equally correct. A study of rifaximin failures in SIBO positive individuals finds biomarkers of decreased Free Androgen Index (FAI), high incidence of autoimmune disease and elevated Sex Hormone Binding Globulin (SHBG). The author hypothesizes that the underlying pathophysiology is increased exposure to Endocrine Disrupting Chemicals (EDCs) which hormonally act as xeno-estrogens. These xeno-estrogens increase the host production of SHBG, reduce pituitary stimulation of androgen product and result in a shift to estrogen dominance. Estrogen dominance is associated with autoimmune diseases and catabolic states. Treatment with a mixture of anabolic steroids that raises the FAI and lowers SHBG results in dramatic improvement in the signs and symptoms and recovery of the vast percentage of severe SIBO sufferers the author has treated. Similar results have been seen in severe pre-surgical cases of IBD whom fail all pharmaceutical interventions. Based on the recent recognition of the biological importance of Wolbachia in the occurrence of major diseases in the underdeveloped countries such as onchocerciasis, and the sexual nature of Wolbachia's role in helminths reproduction, the author hypothesizes that the EDCs are shifting the host's hormonal milieu in a more estrogenic direction and increasing reproduction of helminths changing the gastrointestinal microbiota. Present allopathic treatment of onchocerciasis utilizes albendazole and avermectin as therapy against the microfilaria larvae and doxycycline as bactericidal for Wolbachia. The allopathic treatments are unacceptable for pregnancy and children. Both naturopathic and allopathic treatments share a common focus on the suppression of the underlying bacterium Wolbachia infestation. The author hypothesizes that treatment of these two very different gastrointestinal diseases involves first establishing a normal, anabolic hormonal milieu and concurrently controlling an underlying yet unrecognized microfilaria overgrowth through naturopathic and allopathic treatments prescribed to the host. A case report of one such critically ill individual is noted. A thorough case controlled observation of symptoms matched with biological culture colony count and concentration of microfilaria in disease before and after the aforementioned anabolic treatment may answer the hypothesis.

MeSH terms

  • Adult
  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections / pathology
  • Colitis, Ulcerative / pathology
  • Crohn Disease / pathology
  • Endocrine Disruptors / adverse effects*
  • Environmental Exposure / adverse effects*
  • Estrogens / adverse effects
  • Female
  • Humans
  • Intestine, Small / drug effects*
  • Intestine, Small / microbiology*
  • Intestine, Small / parasitology*
  • Male
  • Microfilariae / growth & development
  • Models, Theoretical
  • Nematoda / growth & development*
  • Rifamycins / therapeutic use
  • Rifaximin
  • Testosterone Congeners / pharmacology
  • Treatment Outcome
  • Wolbachia / growth & development


  • Anti-Bacterial Agents
  • Endocrine Disruptors
  • Estrogens
  • Rifamycins
  • Testosterone Congeners
  • Rifaximin