I admit: I am never quite sure whether to treat these parasites when I see them on gut test results, especially if they are at low level. I tend to see if symptoms match and if anything else turns up. If other infections or IBS type symptoms are present, I will give an anti-infection type programme. I most often tweak my Candida Plan and add any specifics into it in the second 'killing' stage.
So, I was interested to see a new Resource video from Alex at Healthpath discussing these two parasites as the so-called 'terrible two'. Not so much that they are terrible in a severity sense, I don't think, but more that they are like troublesome toddlers who often present together.
As usual, as Alex stresses, it is about the gut and body terrain that allows infections that is the most important thing to get right. Why did they get the infections in the first place, and will they likely recur if you just kill 'em off? Who or what is re-infecting them too? Some people are carriers, I think.
What I hadn't quite appreciated, though, was the link with autoimmune disease, which was a good reminder for me. So, now I may also think: Ok, this px doesn't have any of the symptoms I might associate with these two parasites, but do they have a linked AI disease? If so, treat anyway, whether that be with a general all-round gut improvement protocol or an anti-microbial one (or both).
That said: I always wonder what the mechanisms are in these things - is something high because it is trying to help the body in some way? Blastocystis is thought of as a normal part of the healthy gut bacteria by many (see here: https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1009253) but it does seem to have some link to autoimmune thyroid, at least: https://journals.sagepub.com/doi/10.1177/2042018820907013.
For me, it's still a bit confusing as to whether to treat or not. It seems I'm not the only one to ask whether they need treating or not either: https://academic.oup.com/cid/article/54/1/105/369396
Good summary from Burghwood Clinic here and I'll also leave the last word to them:
Why Medicine does not consider these amoebas pathogenic?
Whilst these parasites have been known for over a century, most of the earlier literature has described them as "commensals" i.e. harmless, incidental findings in stool cultures; not all carriers are symptomatic. However, in the last two decades a number of scientific papers published evidence that their eradication is often followed by a significant improvement or clearance of a range of abdominal symptoms, fatigue and other problems not directly related to the intestine.
Can you shed any more light here? What do you do?
Micki