However, since the onset of the COVID-19 pandemic, the National Institutes of Health (NIH) and affiliated health authorities have vociferously recommended against ivermectin as a potential treatment for the virus.
In a social media message that has gone viral, the FDA labeled it as a drug for horses and not fit for human consumption: “You are not a horse. You are not a cow. Seriously, y'all. Stop it.”
The post made headlines and was one of the FDA's most successful social media campaigns. Yet, research findings seem to contradict the public health organization’s recommendations.
Ivermectin: Antiparasitic BeginningsIvermectin made its name through its significant benefits in treating parasitic infections.
In 1973, Satoshi Omura and William C. Campbell, working with the Kitasato Institute in Tokyo, found an unusual type of Streptomyces bacteria in Japanese soil near a golf course.
Despite decades of searching worldwide, researchers have yet to find another microorganism that can produce avermectin.
It was changing one of the bonds of avermectin through a chemical process that produced ivermectin, which was proven successful in treating onchocerciasis and lymphatic filariasis, both of which are debilitating diseases common in the developing world.
Though its broad antiparasitic functions are not well understood, it is known that ivermectin penetrates parasites’ nervous systems, turning off their neurons' actions, possibly deactivating and killing them.
The Onchocerca worms mature in the skin of an infected individual (“the host”). After mating, female worms can release into the host’s skin up to 1,000 microfilariae a day; the female worms live for 10 to 14 years. The presence of these worms can lead to scarring in the tissues and, when microfilariae invade the eye, can cause visual impairment or complete loss of vision.
When Merck distributed ivermectin in areas hardest hit by the disease, treatment benefited the residents' overall health and led to economic recovery. Ivermectin replaced previous drugs that had devastating side effects.
Ivermectin has also proven effective against lymphatic filariasis, known as elephantiasis. Parasitic worms transmitted through the bite of an infected mosquito can grow and develop in lymphatic vessels, which regulate the body's water balance. When certain vessels are blocked, the areas—typically the legs and genitals—can swell, with the legs enlarging to elephant-like stumps.
The World Health Organization listed ivermectin as an essential drug and has advised many countries to run annual campaigns to rid people of these parasites. Such recommendations are a solid testament to ivermectin's safety.
For their work, including the discovery of avermectin, in 2015, Omura and Campbell were among three recipients of the Nobel Prize in Physiology or Medicine.
Ivermectin and COVID-19Analyses of studies on ivermectin have found it effective as a prevention, a treatment for acute COVID-19, and in advanced stages of infection by the virus.
1. Ivermectin as a ProphylaxisProphylaxis intervenes in the first phases of COVID-19 infection, which is mainly asymptomatic, when the virus replicates to increase its viral load—symptom onset occurs after the viral load peaks.
Ivermectin can also enter the cell to prevent the virus from replicating. SARS-CoV-2 needs cell replication machinery to make more of the virus; ivermectin attaches and blocks a protein critical to this process, preventing viral production.
Additionally, ivermectin can be absorbed from the skin and stored in fat cells for a long time.
"Because it's lipid soluble, it is stored and slowly released, [so] once you've taken a prophylactic dose, and I think it's like the cumulative dose of about 400mg, that your risk of getting COVID is close to zero and you can actually stop it for a while," said Dr. Paul Marik, a widely published critical care specialist with 500 peer-reviewed papers to his name, in an interview with The Epoch Times.
Marik co-founded the Front Line COVID-19 Critical Care Alliance (FLCCC), a group of physicians formed in the early days of the pandemic and dedicated to treating COVID-19. According to interviews, many of the group’s doctors have successfully treated COVID-19 with ivermectin. The organization’s other co-founder, Dr. Pierre Kory, has written a book about ivermectin’s use and controversy during the pandemic.
Dr. Sabine Hazan, a gastroenterologist with 22 years of experience in clinical research, told The Epoch Times that she would advise ivermectin use for only a short time in critical patients rather than recommending the use of it as a prophylaxis.
2. Ivermectin for Early and Acute COVIDMany peer-reviewed studies have found that ivermectin, when used by itself or in conjunction with other therapies in symptomatic patients, reduces ventilation time, time for recovery, and the risk of progressing to severe disease. (pdf 1, pdf 2, pdf 3)
This is likely due to ivermectin's anti-inflammatory role in multiple pathways, achieved by clearing out the viral particles by immobilizing them, reducing inflammation, and improving mitochondrial action.
Suppose the early viral replication is not controlled and cleared out soon enough by the body’s immune system. In that case, the infection can become severe or even hyperinflammatory, possibly leading to systemic organ failures.
Ivermectin also likely improves gut health, which plays an essential role in immunity by preventing bacteria and viruses from infecting people via the gut.
“When people die of COVID, they die from the cytokines—they couldn't breathe anymore. It's almost like an anaphylactic reaction. So when you give them ivermectin at the moment they're about to crash, you're boosting the Bifidobacteria [and increasing their oxygen],” Hazan said.
She explained that ivermectin is a fermented product of Streptomyces bacteria. Streptomyces are within the same group Bifidobacteria are from, which may explain why ivermectin temporarily boosts Bifidobacteria.
3. Ivermectin for Long COVID and Post-Vaccine SymptomsThe number of studies supporting ivermectin to treat long COVID and post-COVID-19 vaccine symptoms is limited. However, doctors treating these conditions have observed successful results with ivermectin.
Researchers found that in patients reporting long COVID symptoms—including coughing, brain fog, headaches, and fatigue—ivermectin alleviated their symptoms.
The Changing Public Health Messaging on IvermectinThe NIH’s stance on ivermectin has changed several times.
Early in the pandemic, there was little information on ivermectin as a potential treatment for the virus.
The study's lead author, Dr. Jean-Jacques Rajter, is a critical care doctor specializing in pulmonary medicine.
The day after he saw the Australian study, one of his COVID patients dramatically deteriorated from breathing normally at room oxygen levels to requiring intubation. The patient's son pleaded with Rajter to save his mother using whatever options available. Rajter recognized that hydroxychloroquine would be ineffective in the advanced stages of COVID. After much deliberation, he tried ivermectin.
"The patient deteriorated as expected for about 12 more hours but stabilized by 24 hours and improved by 48 hours. After this, two more patients had similar issues and were treated with the ivermectin-based protocol. Based on experience, these patients should have done poorly, yet they all survived," the testimony read.
The findings encouraged the use of ivermectin among doctors desperate to find a cure.
Meanwhile, by October 2020, research into COVID-19 vaccines and the use of remdesivir to treat the virus was already in full swing.
According to the FDA, specific criteria should be met for the EUA (Emergency Use Authorization) to be granted for vaccines and medications, including that there are “no adequate, approved, and available alternatives.”
Some doctors say that if ivermectin's use for COVID had been approved, it would have made the EUAs for vaccines and remdesivir null and void.
Health Authority OverreachDespite the NIH’s neutral statement on ivermectin for most of 2021, the FDA actively campaigned against using ivermectin in COVID-19 patients. On Aug. 26, 2021, the CDC sent an emergency warning against using ivermectin; a few weeks later, the American Medical Association and affiliated associations called for an end to ivermectin use.
“The fact that it's not FDA approved for COVID is irrelevant because the FDA endorses the use of off-label drugs at the clinician’s discretion,” said Marik.
As an ironic side effect of the messaging on ivermectin, people suddenly found themselves unable to access ivermectin, and some turned to veterinary-grade ivermectin.
Contradictory Research and CampaignsThough the initial research in 2020 showed promising results for ivermectin, published studies reported conflicting findings by the following year.
Individuals can participate in the study once they develop COVID by selecting ivermectin from four other drugs. The drug was sent to them via mail. This method means that some people in the study could have recovered by the time they received the ivermectin.
There are some controversies regarding this study.
The first is that the authors changed the primary endpoints during the study, which is heavily frowned upon as it can affect the validity and reliability of the outcome.
This was changed to the number of deaths, hospitalizations, and symptoms by day 28. In the actual published study, there was another change, with the endpoint being duration of COVID-19 symptoms.
There were also further implementations in the study that could impact the observed effectiveness of the drug.
On average, this study's participants received treatment six days after first reporting symptoms. Patients needed to report eligible symptoms and test positive for COVID-19 before receiving drugs. Due to this added time, about seven percent of the participants had no symptoms by the time ivermectin arrived.
Despite these negative findings for ivermectin, there is still some evidence that may demonstrate that ivermectin can be useful in treating COVID-19.
The percent of probability is below 95 percent, making the benefit of ivermectin insignificant.
The FDA and NIH did not respond for comments by press time.