Entamoeba histolytica: Effective Herbal Treatments

byron bay gut health herbalist naturopath gut health expert natural treatments for parasite infections

Herbs can be very effective when treating parasite infections such as Entamoeba histolytica. This particular parasite, while not as common as  Giardia and Cryptosporidium, needs to be addressed as quickly as possible due to the damage that it can cause in the gut, liver and even the brain.

This article will introduce Entamoeba histolytica, outline why it is a problem that needs to be dealt with quickly and list a few top herbs that can be used to effectively treat this particular gut parasite. 

Entamoeba histolytica an introduction 

Entamoeba histolytica, also known as E. histolytica or even e histo, is a unicellular protozoan parasite. Infection with this particular microbe can lead to amoebiasis, also known as amoebic dysentery. This particular microbe is the third leading parasitic cause of death only coming in behind malaria and schistosomiasis (a parasitic flatworm common in tropical countries) (1).

Entamoeba histolytica can damage the gut wall including the mucosa that lines the gut and the cells underneath it – the epithelial cells. This sets off an inflammatory immune response and in roughly 10% of infected people the parasite can actually penetrate and invade the colon wall causing ulcers and death to the surrounding tissues (2).

Image taken from: Comparative Pathobiology of the Intestinal Protozoan Parasites Giardia lamblia, Entamoeba histolytica, and Cryptosporidium parvum

How Did I Become Infected With Entamoeba histolytica?

As with most protozoan parasites such as Giardia and Cryptosporidium, Entamoeba histolytica is transmitted in the cyst form via the faecal oral route. The cysts are incredibly resistant to environmental pressures and can survive passage through the stomach. Once in the small intestines the cyst form shifts into the trophozoite form which then takes up residence in the large intestine (3).

It is this form that causes all the nasty digestive symptoms. 

If you are more of a visual learner there are a number of graphics that describe this process below.

Image taken from: Entamoeba Encystation:New Targets to Prevent the Transmission of Amebiasis
Image taken from: Amoebiasis: current status in Australia
Image taken from: Comparative Pathobiology of the Intestinal Protozoan Parasites Giardia lamblia, Entamoeba histolytica, and Cryptosporidium parvum

Symptoms of Entamoeba histolytica infection

There are a range of common symptoms that would make me suspect Entamoeba histolytica infection. 

On the more severe side of things we see symptoms such as 

  • Dysentery
  • Diarrhea 
  • Fever
  • Abdominal pains 

Things can get even more serious with this particular infection. It can cause amebic liver, lung and brain abscesses (3).

How to Test for Entamoeba histolytica

Thankfully testing for Entamoeba histolytica is reasonably straightforward. 

Most doctors can order a DNA based stool test that will screen for this parasite with good accuracy. The stool test that is commonly used here in Australia is called a PCR (polymerase chain reaction) test which looks for fragments of the microbes DNA. 

The GI MAP also screens for Entamoeba histolytica using DNA based technology. While I wouldn’t recommend this test for everyone, the GI MAP does include a range of gut markers that could be helpful when trying to find the root cause of your digestive symptoms. Check out the complete guide to the GI MAP here

Overview of natural treatments for Entamoeba histolytica

Natural treatments for Entamoeba histolytica need to take into account the individual person. Holistic medicine can’t be boiled down to one ‘protocol’ that will work on each and every person. This is the issue with conventional medicine. Functional medicine practitioners often fall into this trap as well. 

When looking for information on natural treatments for Entamoeba histolytica we can focus on three core principles.

  1. We need to find and remove Entamoeba histolytica. This can be accomplished with a relatively short prescription of strong herbal antimicrobials formulated with the patient’s presenting symptoms in mind.
  2. Gut health and integrity is the second key principle that needs attention. Here we need to focus on the healing of the damaged gut lining. This is the long-tail approach. With certain patients it can take a month or two to heal and seal the gut wall and rebuild the intestinal wall architecture. This is an incredibly important step to ensure that you are properly digesting and absorbing all the key vitamins and minerals you need to fuel your body and feel optimal. 
  3. Assess nutrient deficiencies and correct them. While step 2 will help get you there, it is a process. Often nutrient deficiencies can impact the immune system, energy production and even neurotransmitter production (zinc, B12, B9, B6, etc). A properly functioning digestive tract is important (hence step 2) as well as a nutrient dense diet. At times supplementation is an important step to get you feeling better faster. 

Now onto herbal medicine to treat Entamoeba histolytica. 

Herbs for Entamoeba histolytica

First off we can divide our herbal medicines into different categories in a number of different ways. 

When we are focusing on the killing of specific pathogenic microbes I like to classify antimicrobial herbs by their active constituents. From there we can make sure that there is a good spread of different constituents to make sure that the bases are covered. These include berberine rich herbs, herbs rich in polyphenols such as flavonoids and tannins and herbs high in volatile oils (often based on the terpene/terpenoid structure).

Berberine rich herbs to treat Entamoeba histolytica

The top of the pile for herbs rich in berberine is the one and only Coptis chinensis. Known as Chinese goldthread or Huang lian, Coptis chinensis is used in Chinese Medicine to treat dysentery and gastroenteritis (4).

The Chinese materia medica is extensive and their understanding of herbs is immense. They look at Coptis as very bitter, very cold, and extremely drying. Something to consider when looking at the constitution of the person being treated (5).

First off it is important to point out that this particular herb is full of berberine, a potent antimicrobial alkaloid. This is why it should be only used when necessary and hopefully under the guidance of a skilled herbalist. While herbal antibiotics are less damaging when compared to the pharmaceutical antibiotics they can still negatively impact the gut microbiota, especially when used long term.  

It is also incredibly cold and very bitter. Chinese herbalists would caution long term use and would be concerned about using it in patients with coldness, yin or yang deficiency or deficiency in the Spleen and Stomach (5).

I think it is wise to take their caution here. The Chinese herbal medicine tradition has a long history of use and they know the intricacies of their herbal materia medica well.

Berberine in Isolation

I am often asked whether the isolated form of berberine, often found in supplements, is a better option. If berberine is the ‘active constituent’ in Coptis then why not simply double down and get a sufficient dose. Here we can circle back to the concept of holistic medicine and some of the issues we have been seeing with antibiotic resistance. Herbs, in all their glory, can have dozens of different active constituents in them. Coptis has over 40 different alkaloids, not to mention a whole array of lignans, phenylpropanoids and flavonoids (6).

Image taken from: Coptidis Rhizoma: a comprehensive review of its traditional uses, botany, phytochemistry, pharmacology and toxicology

Some of the alkaloids are similar to berberine, some differ. This cuts down on antibiotic resistance considerably. Microbes have evolved to resist antimicrobial constituents in plants. Plants have evolved to overcome this resistance by generating a complex array of different antimicrobial constituents. 

Image taken from: Coptidis Rhizoma: a comprehensive review of its traditional uses, botany, phytochemistry, pharmacology and toxicology

Other berberine rich herbs from stronger to weaker include.

Phellodendron amurense,

Yet another Chinese herbal medicine that is used to treat dysentery and diarrhea. 

Goldenseal – Hydrastis canadensis.

One issue with goldenseal is that it is hard to cultivate. Wild goldenseal plants are rapidly disappearing and should be avoided. Compared to Coptis or Phellodendron this herb has less berberine. 

As with all herbal medicines there is a synergy within the plants constituents. Goldenseal also contains at least two other antimicrobial alkaloids known as hydrastine and canadine. Furthermore, certain flavonoids found in goldenseal have been shown to inhibit bacterial efflux pumps (7) – these efflux pumps help bacteria survive in a toxic environment (antibiotics, antimicrobial herbs, etc).

The whole is greater than the sum of its parts is a good approach to herbal medicine.  

Other herbs with much less amounts of berberine include Oregon grape root and Barberry.

I have also come across yet another berberine rich herb called yellowroot (Xanthorhiza simplicissima) which is native to Eastern North America. I am not familiar with the use of this particular herbal medicine but figured it was worth including, especially due to the fact that goldenseal (outlined above) is endangered and cultivated plants are incredibly expensive. 

It is interesting to note that berberine, and berberine-like compounds, can be found in a whole range of unrelated plants all across the globe. 

Polyphenol rich herbs to treat Entamoeba histolytica

It may be a stretch to try and use polyphenols as a category to separate different herbal medicines. This is due to the fact that polyphenols are present in most plants in a number of different forms including flavonoids, tannins or phenolic acids. There is also some crossover with plants that contain polyphenols and the essential oils that we will cover shortly. 

There are a few herbal medicines rich in certain polyphenols that are helpful when looking to treat Entamoeba histolytica naturally. 

Scutellaria baicalensis – Baical Skullcap

Known as baical skullcap this herbal medicine has a number of flavonoid constituents including the flavones baicalin and wogonoside and their associated aglycones baicalein and wogonin. These have been shown to protect the liver and act as antimicrobials. In Chinese herbalism baical skullcap, known as Huang Qin, has been used for thousands of years to treat diarrhea, dysentery, hypertension, hemorrhaging, insomnia, inflammation and respiratory infections (8).

Image taken from: Scutellaria baicalensis, the golden herb from the garden of Chinese medicinal plants   
Image taken from: Scutellaria baicalensis, the golden herb from the garden of Chinese medicinal plants   

Circling back to Entamoeba histolytica we can see some significant overlaps between the traditional indications for baical skullcap and the symptoms of infection from this particular microbe, mainly diarrhea and dysentery.

Pomegranate Husk

Pomegranate husk is one of my favourite herbs for certain parasitic infections as well as bacterial overgrowths and gut imbalances in general. I have written about it before, and it really deserves its own personal article, but let’s summarise its use for Entamoeba histolytica infections here.

Pomegranate husk has a whole range of polyphenols including 

  • Flavonoids – anthocyanins, catechins, and others 
  • Tannins – ellagic acid, gallic acid, punicalagin and punicalin 

The ellagitannins (hydrolysable tannins) are the main polyphenols of pomegranate. They are poorly absorbed and are mostly converted into ellagic acid in the small intestine (9). 

Ellagic acid and the remaining ellagitannins make their way to the large intestine where bacteria convert it into urolithins.

Here we can see the same pattern of a pH drop, making the large intestine more acidic and the resulting decrease in the less friendly bacteria (Clostridia species, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Candida species, and Mycobacterium) and an increase in beneficial bacteria. 

The effect the ellagitannins found in pomegranate husk include (10).

  • Antioxidant
  • Chemopreventive 
  • Anti-inflammatory 
  • Reducing cardiovascular disease 
Image taken from: Anti-inflammatory and anti-cancer activities of pomegranate and its constituent, ellagic acid: Evidence from cellular, animal, and clinical studies. Yellow is reducing and green is increasing. 

What does all this have to do with Entamoeba histolytica? Not much but I figured it was worth singing the praises of such a potent herbal medicine that isn’t getting much air time. 

Back to natural parasite treatments we can see that pomegranate husk does have a number of animal studies showing that it is a potent anti-parasitic. One mouse study found that it to be effective against Giardia (11).

While another mouse study found it to be effective against Cryptosporidium (12). 

Unfortunately there weren’t any studies demonstrating effects against Entamoeba histolytica but clinical experience and traditional knowledge can step in here and we can use the mouse studies on similar parasites to fill in the missing pieces. 

Volatile oil Rich Herbs to Treat Entamoeba histolytica 

The final class of herbal medicines that are commonly used to treat Entamoeba histolytica contain a high amount of volatile or essential oils. There are many different herbs that are rich in essential oils that have demonstrated antimicrobial effects including oregano, thyme and clove.

Thyme (with its long list of essential oils – borneol, carvacrol, cymol, linalool, and thymol) has demonstrated specific anti-Entamoeba histolytica properties in-vitro (13).

Image taken from: Inhibitory Effects of Iranian Thymus vulgaris Extracts on in Vitro Growth of Entamoeba histolytica

Treating Entamoeba Histolytica Naturally

If you have screened for and found Entamoeba histolytica there are alternatives to antibiotics out there that can help to remove this parasite from your gut. 

I would not recommend trying to treat yourself. Of all the parasites I have covered here Entamoeba histolytica is one of the more serious infections and should be dealt with under the guidance of a practitioner. 

byron herbalist todd mansfield gut health specialist

Need help with your digestion?

Hi, my name is Todd Mansfield. I am a clinical herbalist with a special interest in all things gut health.

If you are looking for digestive health support consider working with me. I see people online as well as in person from my clinic in Byron Bay.

More booking information here.

References and Resources

  1. Amoebiasis: current status in Australia
  2. Comparative Pathobiology of the Intestinal Protozoan Parasites Giardia lamblia, Entamoeba histolytica, and Cryptosporidium parvum
  3. Entamoeba Encystation:New Targets to Prevent the Transmission of Amebiasis
  4. Coptisine from Coptis chinensis exerts diverse beneficial properties: A concise review
  5. Chinese medical herbology and pharmacology
  6. Coptidis Rhizoma: a comprehensive review of its traditional uses, botany, phytochemistry, pharmacology and toxicology
  7. Synergy Directed Fractionation of Botanical Medicines: A Case Study with Goldenseal (Hydrastis canadensis)
  8. Scutellaria baicalensis, the golden herb from the garden of Chinese medicinal plants
  9. Anti-inflammatory and anti-cancer activities of pomegranate and its constituent, ellagic acid: Evidence from cellular, animal, and clinical studies
  10. Metabolic Fate of Ellagitannins: Implications for Health, and Research Perspectives for Innovative Functional Foods
  11. In vivo study of pomegranate (Punica granatum) peel extract efficacy againstGiardialambliain infected experimental mice
  12. Pomegranate (Punica granatum) peel is effective in a murine model of experimental Cryptosporidium parvum
  13. Inhibitory Effects of Iranian Thymus vulgaris Extracts on in Vitro Growth of Entamoeba histolytica

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