“Guys….this thing dropped out of my c00ch1e and it’s alive. I need answers please,” the text on the video reads. A lengthy, worm-like creature that could be anywhere from one inch to 10 feet — the scale of the video is unclear — slithers across the screen.

In a stitch of the original video, creator Jackie Pierce holds up a bottle of a popular “parasite cleanse,” a supplement sold in many big-box stores containing a blend of wormwood, clove, and fulvic acid. “I started my parasite cleanse and I did see some weird things in the toilet,” she says in the video, before encouraging followers to do a parasite cleanse “at least once a year.”

“Did that lady lie in the video about things falling out of her coochie? Maybe. Maybe,” she says. “But parasites do exist in us.”

The video, which garnered more than 1.8 million views before it was removed from the platform, is one of many parasite-cleanse videos being pushed by TikTok Shop, TikTok’s new in-app shopping feature, which rolled out in the United States last week. In addition to advertising cosmetics, perfume, and trendy houseware products, TikTok Shop also has been promoting ads for parasite cleanses, with users posting gruesome photos of worms or “parasite eggs” that have come out of their bodies after using the products. They have been promoted as cure-alls for everything from diarrhea to bloating to brain fog to even autism.

The problem: gastroenterologists who spoke with Rolling Stone believe that such products are far from evidence-based. Indeed, because they are not FDA-approved and are therefore unregulated, they may actually cause genuine harm.

“I believe this is made up,” Rabia de Latour, MD, she/her, gastroenterologist and assistant professor of medicine at NYU Grossman School of Medicine. “People do this and the numbers of followers they get increases. By saying you’re seeing in this toilet bowl, they are getting clout in this strange world of alternative remedies.” (Pierce did not respond to a request for comment.)

The video was delisted from TikTok Shop, and appears to have been removed. Two other videos Rolling Stone sent to TikTok for review selling a parasite cleanse are still on the platform, but have also been delisted. A TikTok spokesperson told Rolling Stone that TikTok Shop prohibits the sale of medicines, medical devices, and medicinal supplements at this time, including “unlicensed medicines, herbal or homeopathic products,” per TikTok Shop guidelines. These guidelines also specifically prohibit the “promotion of unscientific product claims” or “exaggerated claims about a product’s features, functions, or effects,” all of which are clearly displayed in the half-dozen or so TikTok Shop videos Rolling Stone saw recommended on the For You page touting parasite cleanses.

As Rolling Stone previously reported, parasite cleanses have long been popular on TikTok. Currently, videos under the #parasitecleanse hashtag have garnered more than 740 million views, with such videos touting holistic remedies that can “heal the gut” by purging the body of parasites and heavy metal toxins. Such videos claim that parasites are often the culprit behind common gastrointestinal complaints, such as diarrhea, constipation, or bloating, and are often paired with gruesome imagery of worms and creepy-crawlies pictured at the bottom of a toilet bowl.

Many of the claims stem from age-old pseudoscientific beliefs that such cleanses can treat conditions like “leaky gut,” or the belief that weak intestinal walls can cause toxins to enter the body or lead to yeast overgrowth. One TikTok Shop video which is still on the platform and has nearly two million views regurgitates these claims, touting a “candida cleanse” that can treat chronic fatigue and sugar and carb cravings that also “kills parasites too.”

Beth Schorr Lesnick, MD, director of the Gastroenterology Fellowship Training Program at Westchester Medical Center, dismisses such claims. “Many patients come and they’ve gone to a naturopath and they’ve told them they have this leaky gut and we say, ‘We don’t believe its a thing,’” she says, adding that it is uncommon to have intestinal yeast overgrowth unless you are immunosuppressed in some way. “It’s not in the medical literature at all.”

More to the point, while parasitic infections are indeed a thing, ads for parasite cleanses on TikTok Shop grossly misrepresent how common they are or how they actually present. The most common parasitic infection in the United States, says De Latour, are probably pinworms, or white, parasitic worms that are found in the large intestine and can cause anal itching. (One interesting, if not disgusting, side note for pinworms is they are most commonly diagnosed via what De Latour calls a “Scotch tape test,” or putting a piece of Scotch tape around the anus before bed and seeing if any of the worms stick to it in the morning.) But pinworms are most often found in preschool-aged children, says De Latour, and the worms are about the thickness of a dime — a far cry from the thick, lengthy, creepy-crawlies seen in the TikTok Shop videos.

There are parasitic infections that can cause larger, more visible worms, such as ascaris lumbricoides. But it is far more common in developing countries than the United States, and presents with far more severe symptoms than bloating and diarrhea, such as severe vitamin deficiencies, malnourishment, and abdominal distension. (Unlike the wriggly creature in Pierce’s stitched video, they also tend to be white, says De Latour: “I’ve never seen a black one,” she says. “I think that video is fake. People are weird.”)

While parasites do exist, they are far less common — and far less dramatic-looking — than the cleanses on TikTok Shop would suggest. Schorr Lesnick estimates that she has treated only about three or four cases in the past 15 years. “It’s extremely rare to pick up weird parasites, whether in the office setting or in the inpatient population that I come across,” she says. “I’m not sure who’s seeing these patients.”

Further, there could potentially be severe risks that stem from taking unregulated supplements sold on TikTok Shop, particularly considering such videos do not contain disclaimers that such products are unapproved by the FDA. As Rolling Stone previously reported, such cleanses have been linked to GI distress in small children, such as diarrhea, as well as potentially harmful interactions with prescription medications. And though De Latour has never treated a patient who has taken such a cleanse, she says it is “unfortunately very common” to see patients present with liver failure after taking an unregulated supplement. “Our first question is always, ‘Did you take a rare medication or a supplement?,’” she says.

The fact that TikTok Shop is also allowing creators in their affiliate program to directly profit off such products, while simultaneously failing to add any disclaimers warning about their regulation status, is also cause for concern, says De Latour. (A TikTok spokesperson told Rolling Stone that vendors undergo a verification process before listing items, including “having independent third parties verify information provided by sellers.”) “The way Instagram is trying to put banners on these things and be responsible, TikTok should have something similar like, ‘This has not been FDA approved,’ so someone who isn’t young and easily influenced can’t take a supplement that can harm them,” Delatour says.

Ultimately, De Latour feels that the symptoms described by many of the folks trying out parasite cleanses likely have nothing to do with parasites at all: “it sounds like IBS to me,” she says. While she says that she does believe alternative therapies can potentially serve as a palliative for many “modern medical problems,” parasite cleanses, she says, are “not it.”

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