Reader can’t get diagnosis of parasites

Dear Dr. Roach: I’m looking for some answers or some advice, please. I’m crying out for help, and no one seems to care. Doctors just look at you like you’re crazy, but I feel like our lives are in danger.

I have a parasite. My sister has had a parasite in her for a couple years now. She has been to several doctors and not one has tested her for parasites. The sad part is one of my babies also has it, I believe. He is 10. Please help us.

Anon.

Answer: I hear this concern from readers often, at least several times a year, and occasionally from patients in my own internal medicine practice. For anyone who suspects infection with a parasite, the first step is a careful history to evaluate for sources of exposure.

Documenting travel history and contact with other people or environments where a parasite may be picked up is paramount, as is a careful skin exam. Blood tests such as an eosinophil level — a type of blood cell that is increased in many parasitic diseases — can be helpful, and occasionally stool tests are of benefit.

Very rarely, vitamin deficiencies can cause symptoms that resemble parasites, and treatment of the vitamin deficiency resolves the symptoms.

It is often the case that a parasite cannot be found. Sometimes, even if a parasite is not present, or is no longer present, biochemical changes in the body — as well as the attendant anxiety about having a parasite — can cause persistent symptoms that can dramatically interfere with a person’s quality of life.

In patients where no evidence of current parasites is found despite a careful evaluation, treatment can still be extremely helpful.

For some people, symptoms have been entirely relieved with medication treatment.

Medication is quite effective, although sometimes it takes time to find the right one. Once the right medication is found, symptoms usually slowly go away over a period of a few weeks to several months. Lifelong treatment is not necessary.

Treatment of this condition is challenging and requires a doctor or specialist who is expert in evaluation of parasites and skin conditions and who will listen to the patient’s concerns.