Ivermectin now a quack cure-all

During the second and third years of the COVID pandemic, skeptics began to hear more and more of an anti-parasitic drug that had been used frequently for animals and less so for humans.

Ivermectin has been approved by health authorities to treat humans with strongyloidiasis and onchocerciasis (river blindness): conditions that are caused by parasitic worms. Also there are topical ivermectin preparations used to manage skin conditions such as rosacea and external parasites such as head lice. Used as prescribed it is quite safe and has improved the lives of countless individuals in developing nations. Yet we weren’t hearing about ivermectin used in this manner. Thanks to disinformation and irresponsible repetition of dubious claims, ivermectin was being promoted as a means to combat COVID-19.

The anti-vaccination movement embraced ivermectin because it resonated with the “my body, my choice” mantra. Right leaning media identities promoted it in much the same illogical way as they had hydroxychloroquine. It had been used safely for decades, they argued, and thus was clearly a sound choice to combat COVID-19 symptoms. Yet hydroxychloroquine, had a pharmaceutical history as an anti-malarial and an agent to manage symptoms of arthritis and autoimmune disease, not in treating COVID-19. Ivermectin similarly, had no clinically proven background in the treatment of COVID-19. The clinical trials had simply not been done.

For skeptics, the issue was and is quite simple. Look toward reputable sources. Seriously examine the arguments in favour of ivermectin. Review the strength of research being cited. Place the issue in context. Keep an eye out for ideology. Check the profiles and backgrounds of key players, and so on. In short: Seek the evidence.

Initially there was the 3 April 2020 media release from Monash University. The Monash Biomedicine Discovery Institute announced a paper published in the peer reviewed journal Antiviral Research. The title, The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro, was tantalising. An informative piece published in the Sydney Morning Herald on 22 October 2021 cites experienced drug developer Dr. Craig Rayner referring to the impact of the announcement:

“It was incredibly hyped,” Dr Rayner said. “I knew it was going to start a fire.” […]

“It’s not the best thing for Australia to become known for in terms of its contribution to the pandemic,” Dr Rayner said. “But that’s what it is, unfortunately. It has promoted vaccine hesitancy and people are dying because they’re taking a veterinary medicine that has not been proven.”

For those looking to grab the ivermectin ball and run with it, the media release was peppered with big names, other nasty diseases and potentially exciting findings. It has since been modified to include an FDA warning and offer clear disclaimers about ivermectin’s effectiveness. What mattered to those who would go on to push ivermectin as a safe cure for COVID-19, came from just a few paragraphs:

A collaborative study led by the Monash Biomedicine Discovery Institute (BDI) with the Peter Doherty Institute of Infection and Immunity (Doherty Institute), a joint venture of the University of Melbourne and Royal Melbourne Hospital, has shown that an anti-parasitic drug already available around the world kills the virus within 48 hours.

The Monash Biomedicine Discovery Institute’s Dr Kylie Wagstaff, who led the study, said the scientists showed that the drug, Ivermectin, stopped the SARS-CoV-2 virus growing in cell culture within 48 hours. 

“We found that even a single dose could essentially remove all viral RNA by 48 hours and that even at 24 hours there was a really significant reduction in it,” Dr Wagstaff said.

Ivermectin is an FDA-approved anti-parasitic drug that has also been shown to be effective in vitro against a broad range of viruses including HIV, Dengue, Influenza and Zika virus. 

Dr Wagstaff cautioned that the tests conducted in the study were in vitro and that trials needed to be carried out in people.

For those of us even broadly familiar with how drugs are brought to market, it was that final line above that mattered. Early lab results do not equate to clinical trials. Indeed shortly after the announcement, effort and funding across the globe was directed to clinical trials of ivermectin. Yet it would take almost eighteen months before enough studies were done, presenting enough evidence to show that ivermectin does not hold promise as a treatment for COVID-19. Over 2021, the number of news articles heavily critical of the “dubious” apparent “miracle cure” rose steadily such as here, here and here. The BBC published a powerful article on the “false science” backing ivermectin. Flawed data, fake evidence and poorly designed and written research was common.

Australia watched on as Malcolm Roberts, George Christensen, Craig Kelly and Clive Palmer promoted (and still promote) ivermectin. In the absence of evidence ivermectin could not be prescribed for COVID-19. This led to proponents sourcing and ingesting veterinary-grade ivermectin. It soon became clear from social media that many were taking excessive doses very often. On 21 August 2021 the FDA tweeted, “You are not a horse. You are not a cow. Seriously, y’all. Stop it.” That tweet links to accurate FDA information on the dangers of using ivermectin.

A Cochrane review in July 2021 examined completed and ongoing trials of ivermectin for preventing and treating COVID-19. The conclusion read in part:

The completed studies are small and few are considered high quality. Several studies are underway that may produce clearer answers in review updates. Overall, the reliable evidence available does not support the use of ivermectin for treatment or prevention of COVID‐19 outside of well‐designed randomized trials.

On 10 September 2021 Australia’s Therapeutic Goods Administration restricted the prescription of ivermectin to TGA-approved conditions. Yet the belief persisted that ivermectin offered some immediate value. This was compounded by the almost feverish efforts of antivaxxers and others opposed to any official public health advice related to COVID-19. Craig Kelly and George Christensen were criticised for dropping Dr. Kylie Wagstaff’s name in Parliament as they pushed misinformation. Meanwhile, the Big Pharma conspiracy held that ivermectin was misrepresented, suppressed and even ridiculed so that billions of dollars could be made from vaccines. Gradually, online groups began to increasingly offer dose-specific information, encouraging regular ingestion of veterinary-grade ivermectin. Evidence of vaccine effectiveness in preventing severe disease and saving lives had no impact on these groups.

We entered the third year of the pandemic and ever so slowly, moved on into the fourth. Ivermectin tended to draw attention on special occasions, such as when George Christensen tested positive for COVID-19 and touted its use as part of his treatment regime. Craig Kelly who had won the Australian Skeptic’s Bent Spoon award in 2021, confirmed his worthiness as a winner in helping bring ivermectin promoters Peter McCullough and Pierre Kory to Australia just last month. In general however, nothing new about ivermectin caught my attention. Until about three weeks ago.

One day I was out walking listening to an episode of Coronacast in which Megan Taylor and Norman Swan discussed a February 2023 publication on a new trial looking at the efficacy of ivermectin. It too found ivermectin had no beneficial effect. Skeptical Raptor also covered this study and made the disturbing observation that ivermectin is being pushed to treat flu and other respiratory conditions. One hopes efforts to promote the imaginary scope of ivermectin will not lead to more wasted research funding. As Tegan observed there must come a time when it’s accepted funding can be better used elsewhere. Norman summed up his thoughts.

“I suspect this was funded in 2021 and got going in 2022. I’d be very surprised if any funding agencies are funding any more trials into ivermectin. How many more times do you have to replicate? None. We’ve done it.” 

So I kept on walking, metaphorically leaving ivermectin on the pavement behind. Until a couple of weeks later when I heard the name Danny Lemoi. Lemoi ran Dirt Road Discussions, a pro-ivermectin Telegram group with over 136,000 subscribers that also offered advice on dosing children. An online obituary announced that he “died unexpectedly” on 3 March. According to VICE Lemoi had taken a daily dose of veterinary ivermectin since 2012, following a diagnosis of Lyme disease. Administrators of his social media channel revealed that Lemoi’s heart “had almost doubled in size from what it should have been”. They added that lab tests last year had shown “no cause for concern”, dissuading him from having further tests.

Lemoi himself believed ivermectin had “regenerated” his heart muscle and reported that he had ceased all other treatments shortly after he began taking the horse and cow dewormer. Family members and administrators of his Telegram channel have not confirmed or denied the possible role ivermectin played in his death. However, it is being widely speculated that his death is due to known side effects of the drug. Reading various articles gives a picture of a man potentially at risk of familial cardiac problems who distrusted medical doctors. Ultimately however, his passing does not make a remarkably informative statement about ivermectin.

What really stands out in the midst of this development is twofold. Firstly, it is now clear that ivermectin is being used to “treat” more than just COVID-19, including ovarian cysts, depression and even cancer. Secondly, the many ghastly harms, both real and invented, that parasites pose to humans are discussed in certain online groups, convincing members to regularly use veterinary-grade ivermectin. The group Lemoi founded is heavy on conspiracy theory and wild disinformation. This isn’t helped by the fact Telegram has no policy targetting harmful content. The slide show below is of various memes posted to the group over an hour or so.

Click the side arrow or swipe to cycle through images

In the same group, members were also reporting a range of nasty symptoms since beginning ivermectin, VICE reported. One described shin splints, restless leg syndrome, tight calves and “pain in the bones”. Another member took a full syringe of ivermectin in three days; enough for 1,320 pounds of horse. She reported extreme abdominal discomfort, pain, sweating, rapid heart beat and “hot flashes” that went on all night. It was likely an eight feet long tape worm “curled up in my digestive tract” that ultimately died, she reasoned. There are similar stories from others that have taken on Lemoi’s ivermectin “protocol”. Some have accepted his claim that symptoms are a result of “herxing”, which is a quack abbreviation of Jarisch-Herxheimer reaction (JHR); a condition effecting patients who have taken antibiotics to treat conditions caused by spirochete bacteria.

More frightening is the offshoot from Danny Lemoi’s group. Lemoi had offered a veterinary ivermectin protocol for children in his Dirt Road Discussions group. Eight months ago a new group, Learning to Fly was established specifically, “for mom and dads with kids on the spectrum”, according to the founder. It’s populated by parents with children who have autism, Asperger’s Syndrome, Down Syndrome and other conditions. Just as with Lemoi’s group, serious side effects are reported and disregarded by moderators and other members, as normal or part of the healing process.

David Gilbert at VICE has written about Lemoi and the offshoot group. In a recent article he reported on chat content from Learning to Fly:

“I have been applying Ivermectin liquid to my granddaughter’s feet, belly button, and swabbing her ears for six weeks now. She complains of sporadic blurry vision and sometimes headaches.” 

“Bleeding or mucous or vomiting or diarrhea or acne or pealing or aches/pains or hot flashes & sweating are all good signs of clearing out your body,” another member wrote. “This is healing, keep going.”

It’s deeply concerning to see adults actively encouraging the administration of harmful substances to children. Unlike hydroxychloroquine, there has always been veterinary-grade ivermectin. That availability permitted an evolution of use from an anti-vaccination alternative, to cure-all quackery along with the growth of supporting neo-ivermectin groups.

Over at Science Based Medicine, David Gorski has explored the similarities between ivermectin and MMS; the so-called “water purifier” Miracle Mineral Solution. MMS is a form of bleach with 28% sodium chlorite. According to Australia’s TGA it should be labelled as “POISON” and has been responsible for the hospitalisation of Victorians. Its role in “curing” autism, as the quack masters put it, is as an agent that kills intestinal parasites. Readers here may be familiar with “rope worms”. After ingestion of MMS, or even turpentine, lining of the GI tract would burn away only to be salvaged from the toilet by eager parents as evidence the “autism-causing” parasites were being killed.

Now of course, with neo-ivermectin being used to kill those pesky parasites the explanation has adapted. David Gilbert reported that the folks at Learning to Fly have it covered:

“Best way to explain it is [the kids] have a cluster of parasites that are in a part of the brain that causes outbursts. When the parasites in that part of the brain get attacked [by ivermectin] the parasites panic and release their toxins as well as get active. Their death dance,” the channel guidelines state. “This will affect the kiddos and their behaviors.”

So now, just short of three years since the announcement that ivermectin kills SARS-CoV-2 in vitro, veterinary ivermectin is being used by adults and given to children to kill parasites they believe cause a range of maladies. Ivermectin approved for humans, exclusively targets parasitic infections. These conditions are well understood, as is the role of ivermectin in combating them. There is no evidence that regular use of ivermectin will improve health. Indeed ivermectin can interact with a range of other medications. There is certainly no evidence that regular, unsupervised use of veterinary-grade ivermectin in large doses is of any benefit. Nausea, vomiting and diarrhoea are common side effects. Anecdotal data from online chat groups indicate that those using ivermectin this way are presenting with very unpleasant symptoms, and remain unaware (or unrepentant) when it comes to risks.

Ivermectin is still presented as a “wonder drug” for COVID-19 by certain identities such as Pierre Kory. Yet with claims criticised and papers retracted, their influence will remain controversial and dismissed by health authorities. On the other hand the internet has always provided sanctuary for those who feel their belief in dubious alternatives to medicine, is not taken seriously. That entire dynamic received a boost during the COVID pandemic and ivermectin found new ground as a quack cure-all. The most recent group, encouraging the dosing of children with veterinary-grade ivermectin is only eight months old.

For interested skeptics it is very much a case of watch this space.

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