Former GP: “For 22 Years I Told Women Over 60 It Was Their Age. I Should Have Been Looking for Worms.”
The scales haven't moved in years, yet the waistline keeps growing and the evenings keep getting worse? After 22 years in general practice, this is what hides under a layer no stool test can see, and what finally clears it.
If a GP has ever put it down to your age, menopause or IBS, I'm sorry. For 22 years, I was that GP.
If you're over 60 and the scales have barely moved in years, while your waistline keeps creeping out.
If your waistband is digging in by six o'clock, and you can't wait to get out of your clothes.
If every result came back normal, and you knew something was still wrong.
Then you're owed the explanation I never gave in my consulting room. Age was never the reason.
One of my patients showed me what it is, on her phone.
What I saw explains the swelling, the evenings and the normal results. It also led me to what finally clears it.
I Said “It's Your Age” for 22 Years. One Patient Proved Me Wrong.
I'd say some version of “You're female, you're middle-aged, it's menopause,” then look down and type my notes.
She was 64, a retired Year 6 teacher, a nan of five. She'd done everything right. She walked every morning and ate less than ever.
The scales read the same as on the day she retired. Her waistline had grown for two years anyway.
Three stool samples and a colonoscopy, all clear. I'd told her twice it was her age. The second time I gave her the IBS leaflet.
The third time, she didn't sit down. She put her phone on my desk and said, “Please don't give me the leaflet. Just look.”
Ten days into a cleanse her sister had sent her, she had checked the toilet bowl and taken a photo.
It was my twenty-second year in general practice. I studied that screen for a long while. Then I got up and closed the door.
Worms. Dozens of them, white and thread-like, one as long as my little finger. Three stool tests had found nothing. They had been anchored in the lining of her bowel, beneath a layer of grey mucus, and they are anchored there in far more women than anyone tests for.
Her sister's cleanse was not a single herb from a health food store. It combined three, wormwood, black walnut hull and clove, in one oil-based softgel. Remember that detail.
Ten Minutes, Bulk-Billed: Why Every Test Came Back Normal
I kept saying it because I had ten minutes with each of you, bulk-billed. Ten minutes allows a blood test, a stool test and sometimes a referral for a colonoscopy.
They came back normal, so I said it: “It's your age. You'll have to learn to live with it.”
Those tests were never going to find it.
A stool test is a snapshot. A few grams, collected on a single day. Eggs are released in waves, so most samples look clean.
It detects what has been shed, not what is anchored. Anything holding on to the bowel lining, beneath that mucus, stays invisible.
A colonoscopy isn't a parasite test. It looks for polyps and inflammation, not for worms in the lining.
A normal result doesn't mean nothing is there. It means nothing was in that jar, that morning.
The system wasn't built to look. You were never the problem.
The Scales Stay Put. The Waistline Doesn't.
I brushed you off. Here's what you told me, and what I didn't hear.
You'd step on the scales and see the number from ten years ago. By six o'clock you looked six months pregnant, and the waistband had to be loosened.
Your wardrobe quietly went up a size. You started avoiding the camera at family lunches.
And you still say it to each other, the way you said it to me:
“I should have a flat stomach because a CT scan for another reason shows that I only have a very thin layer of fat on my abdomen because of my healthy eating.”
“I used to hate elastic waistbands but now can see the logic. My advice though is to keep them hidden at all times.”
Some of you left my room believing it was in your head, or menopause, or your own fault.
It wasn't. You knew something was wrong long before anyone listened.
They Take Their Share of Every Meal First. That's Why Eating Less Never Worked.
That evening I started reading. Intestinal worms anchor themselves in the bowel lining and shelter beneath a thick layer of grey mucus. Funeral directors, embalmers and mortuary staff have described that coating for decades. In 22 years, nobody ever taught me to look for it.
Here's the piece of the puzzle nobody gave you. They take their share of every meal first.
However little you eat, they are fed first. What's left ferments, and the swelling builds a little more each evening, until it stops settling at all. That's swelling, not weight, which is why the scales stayed put while your waistline grew.
Let me say it plainly, the way I never did in clinic.
Age, menopause and IBS were never the cause. There is something in your bowel lining, fed before you are. And it can be cleared.
Their activity peaks in the small hours, which is why so many women wake around three, wide awake, with a churning stomach. Same hour, most nights, because it follows their feeding cycle.
The rest fits too. They take your iron, so you're nodding off long before bedtime. Their waste is the fog, and the word that won't come.
Clean, Careful Women Carry Them for Years
My patients said it to my face: “Worms? Me? I'm clean. I'd know.”
So did I. It has nothing to do with being clean. The eggs are smaller than a grain of salt.
They're on the salad you washed, the dog asleep on your bed, your grandchildren's hands, the buffet on the cruise.
Most of my patients had no itch and none of the “usual signs” either. The ones anchored in the lining cause swelling instead.
You didn't do anything wrong. You ate.
Five Things You Tried, and Why Each One Failed
Peppermint oil and the IBS leaflet. I handed out both. They ease the cramps, and never touch what's feeding first.
The wind and spasm remedies from the chemist. They settle the wind and the cramps for a day, but never reach the lining. One of you summed it up: “Days when it works and days when it doesnt. Disappointed and mystified.”
Probiotics and fibre drinks. Good bacteria and fibre, poured into a gut where something else is still fed first.
Low FODMAP, and cutting out the bread and the wine. Less food for you. They still take their share of whatever you do eat.
Single-herb cleanses from a health food store. One plant, a small dose, two weeks. Too weak to get through that mucus layer.
The eggs hatch in waves beneath that layer, and the last ones take until close to the end of the third week. Stop on day fourteen and the ones you missed restart the cycle.
None of that was your fault. Those treatments were aimed at the wrong thing, and you kept looking anyway.
Three Herbs Together Reach the Lining. Thirty Mornings Outlast the Eggs.
In 2015, the Nobel Prize in Physiology or Medicine went to the discovery of a compound from a plant of the wormwood family. That family is where the first of the three herbs comes from.
Wormwood works on the mucus layer itself. In a controlled trial published in Veterinary Parasitology, wormwood extract cut parasite egg counts by 90% in 15 days in infected sheep, matching albendazole, a prescription worming treatment.1 In mice, the researchers found it comparable to praziquantel, the prescription treatment for the dwarf tapeworm, a worm that infects people too.2
Black walnut hull turns the bowel lining into hostile ground, so they can't hold on.
Clove targets the eggs. In the lab, its active compound, eugenol, stopped parasite eggs from hatching.3
Around fifteen supporting botanicals go in with them.
A small dose of one herb, for two weeks, can't get through that layer. The three combined, at a real dose, for thirty mornings, reach the lining and outlast the last hatching.
My Five Rules Before You Buy Any Cleanse
I give patients five rules for choosing any cleanse.
- A combination, not a single herb.
- A dose printed on the front.
- In an oil, not a powder.
- Thirty days, not fourteen. Long enough to outlast the last hatching, around the three-week mark.
- A guarantee you can use, and no subscription.
I ask every patient what they took. One name keeps coming back, from the ones who are flat by dinner: PURAVA. It was the one her sister had sent her.
I've read the label and the small print. Here's how it does:
- A combination? Yes. Wormwood, black walnut hull and clove, together in each softgel.
- A dose on the front? Yes. The equivalent of 6,600 mg a serving, printed on the front of the pouch.
- In an oil? Yes, a softgel. The bitter compounds are carried in oil, so they absorb instead of passing straight through, and you taste nothing.
- Thirty days? Yes. Three softgels each morning, for thirty mornings. Most of my patients take them with a cup of tea or coffee in the morning.
- A guarantee you can use? Yes. Sixty days, every penny back, keep the pouch, no subscription.
Picture tomorrow morning: three softgels and a cuppa. Then picture six o'clock four weeks from now, with your waistband still comfortable.
Day 9 to Day 30: What My Patients Report
Week one: more trips to the toilet. Things start moving.
Days 9 to 14: many see them leave when they check the bowl.
Week three: the swelling starts to come down.
Week four: clothes fit again, sleep returns, and the family starts commenting on how well they look.
I went and read their reviews: 16,343 of them, 4.8 out of 5, from more than 56,000 people. The ones that stayed with me had all heard the same line about their age:
“Every test said normal and my GP said it was my age. Day 11 I looked before I flushed. It was never my age. Flat by dinner now.”
Linda, Ballarat
“Every test came back normal. Day eleven I saw them in the toilet and sat on the bathroom floor and cried, because I was not making it up.”
Diane, Brisbane
“A woman at church asked when I was due. I said July, it was easier. Thirty mornings later I wore the green dress to her daughter's wedding.”
Bev, Penrith
“Up at 3 am for years, hand on my stomach. Now I sleep till six.”
Karen, Adelaide
Normal at 65 Is a Belly That Settles After Dinner
Here's what normal looks like at 65. You eat your dinner, and the swelling has settled by bedtime. You sleep through.
Your weight never moved, so your waistline shouldn't have either. If it's been two years, that's more than seven hundred evenings with the button undone. Seven hundred dinners they were fed first.
Five Questions My Patients Ask Before They Start
“Is it safe?”
For most adults, yes. It's a herbal supplement, not a prescription medicine. Don't take it if you're pregnant or breastfeeding, under 18, have epilepsy, liver or bile duct disease or a ragweed or tree nut allergy, or if you take blood thinners. It contains walnut.
“I'm on omeprazole, HRT or thyroid tablets.”
Keep taking everything you've been prescribed. Show your pharmacist the pouch; every ingredient is on the back.
“Isn't it too late at my age?”
No. Your age is the only reason you were told to live with it. The worms don't care how old you are.
“Will I feel worse before I feel better?”
Some women feel a bit rough around days 4 to 7 and go to the toilet more often. That's them dying off. Drink more water and keep going.
“What if I don't see anything come out?”
Eggs and larvae are too small to see. You'll know by your evenings, and if you don't, the sixty-day guarantee covers you.
Four Weeks Later, She Came Back
She came back on a Thursday afternoon, without an appointment, just to show me.
A fitted navy dress with a belt, done up on the last hole. Flat, at five o'clock in the afternoon.
“I slept eleven till six,” she said. “Every night this week. My husband keeps asking what I've had done.”
At the door she turned around. “I wasn’t making it up, was I?”
No. She wasn't. And neither are you.
So picture your own evenings, four weeks from now. A long lunch at your daughter's, dessert too, and nothing to loosen.
Playing with the grandkids without running out of puff. Christmas lunch in the heat, in something fitted, smiling for the camera. Your swimsuit at the beach this summer.
Tonight
Tonight you'll have dinner, and by six o'clock you'll feel it start. The waistband digging in, then the quiet loosening of the button when nobody's looking. Tomorrow someone will tell you, again, that it's your age.
Your age has nothing to do with it. A normal test was never the all-clear you were told it was.
Tomorrow morning can be morning one of thirty.
Two Pouches, One Price, Charged One Time
PURAVA is sold through its own website. When I last checked, they were doing buy one, get one free: one pouch is A$69.99 and the second one is free, charged one time. That's two full thirty-day protocols, under A$1.20 a day.
Most of my patients pass the second pouch to their husband, a sister or a daughter, since worms travel between people who share a home.
Most of the women who stay flat don't stop at one clear-out. Worms come back the way they came in: the dog, a holiday, a bag of salad. So they clear it now, and do it again in six months.
For that, they also do buy two, get two free: four pouches for A$99.99, with their De-Bloat Belly Roller free. Two for now, two for six months from now, or enough for two of you.
Delivery is free, and there's no subscription.
The guarantee is the part I always check. Theirs runs sixty days.
Take the full 30-Day Protocol. If it does not work for you, they refund every penny. Keep the pouch. Nothing to post back.
Stock does run out now and then, because the wormwood is harvested once a year and made in small batches. So I wouldn't leave it for next week.
Picture waking up flat, and catching your reflection on the way to the kettle.
The button opens their order page. It looks like a shop, because it is one. Your choice is already selected, you pay once, and nothing renews.
See two pouches for A$69.99 ›See four pouches for A$99.99 ›
You have two choices tonight. Keep doing what you've been told: loosen the waistband, book the next test, hear it's your age. Or start tomorrow morning, with sixty days to change your mind.
Picture the next family lunch, and nobody asking when you're due.
You weren't imagining it, and you never were. You knew. Now stop feeding what's feeding on you.
Dr Richard M.
References
- Tariq KA et al. Anthelmintic activity of extracts of Artemisia absinthium against ovine nematodes. Veterinary Parasitology, 2009;160:83-8. PubMed 19070963
- Beshay EVN. Therapeutic efficacy of Artemisia absinthium against Hymenolepis nana: in vitro and in vivo studies in comparison with the anthelmintic praziquantel. Journal of Helminthology, 2018;92:298-308. PubMed 28606189
- Pessoa LM et al. Anthelmintic activity of essential oil of Ocimum gratissimum Linn. and eugenol against Haemonchus contortus. Veterinary Parasitology, 2002;109:59-63. PubMed 12383625
Dr Richard M. spent 22 years as a GP in regional Victoria before moving into private practice focused on the gut. He writes about the symptoms general practice too often puts down to “your age”.