Over the past few months, Ivermectin has made headlines as a possible treatment for COVID as popularized by some celebrities and public figures.  So, let’s examine what Ivermectin is as a medicine, how it works, who it effects, and why is it being used by some for COVID.

The What

So, what is Ivermectin?  Ivermectin is an antiparasitic drug that is often used to treat or prevent parasites in animals and humans.  Shocking I am sure, because apparently you and your fur baby can take it with some caveats.  Ivermectin was originally extracted from a soil fungus in the 1970’s as it demonstrated properties anti parasitic properties of certain parasitic worms, and was marketed as a de-wormer for pets as Heartgard.  The chemical structure of Ivermectin consists of quite a few five- and six-member chiral carbon rings, with hydroxyl and methyl groups attached.  Kinda looks like your favorite jig-saw puzzle. 

Merck, in 1987 was able to develop a more compatible dosage of Ivermectin to fight river blindness which is caused by microscopic worms spread by black fly bites and migrate into victims’ eyes causing blindness; commonly called River blindness.  It also is used against Lymphatic filariasis, which is caused by worms spread by mosquitoes.  The worms nesting in the lymph nodes distort them and cause terrible swelling of legs and scrotums known as elephantiasis. As a guy, I would want to take all the Ivermectin to prevent that horrific affliction.

The How

Ivermectin works in an interesting way that it doesn’t actually directly kill the worms.  It actually binds to the Parasite retinol-binding proteins (PRBP) secreted by adolescent worms that block the immune system.  In other words, Ivermectin is a blocker to the blocker and allows your immune system to stop the worms from making you blind (or worse; protect your scrotums fellas).  After the parasites have been blocked by the Dikembe Mutombo of medicines, the worms die a slow death and in a matter of weeks function of the affected area may return.

The Who

Ivermectin, contrary to some peoples and organizations belief; has been approved for veterinary and human use for the treatment of some parasitic infections. (looking at you CNN)  So technically Ivermectin can be used by anyone, but is more common in areas where exposure to parasitic worms is elevated.  Despite the indicated usages for Ivermectin it’s clear that like our past medical misfit Hydroxychloriquine, people have been using it for more than what it was intended for.  So let’s talk about the difficult question and often more controversial reason as why?

Why

Much of the people who use Ivermectin use it for its approved and intended use: to fight parasitic worms in animals and humans (like a reverse Earthworm Jim).  However, an increase in prescriptions for Ivermectin has appeared over the past year.  For example, an average of 3,600 prescriptions were issued for pre pandemic (March 16, 2019-March 13, 2020) to a peak of 39,000 prescriptions in the week of January 8, 2021 in the United States.  As scientist, I particularly like to follow trends and make sense of why its happening.  I don’t think we had a huge spike in parasitic worms invading the United States, but we definitely got a huge spike in COVID paranoia.

Warning, I am about to get political so please stop reading if you don’t like your science to intertwined in politics.

When I look at that date of January 8th, 2021 it was a pivotal moment in United States history.  It was a time that both COVID vaccines were available although not widely available, and there was a rise in skepticism of the speed of which the vaccines were developed and if there was a more nefarious motive to the vaccine.  Oh, and let’s not forget the insurrection/coup that happened a couple of days before.  This was a time in which public distrust was at a all-time high.  If the United States government, FDA, and CDC had stock you would have wish you sold it by then.

As I stated in my earlier post on the COVID shot, there are some valid reasons to have mistrust of the speed of the vaccine.  None have highlighted this fact quite like Joe Rogan.  Although Joe Rogan has stated he is not an anti-vaxxer, Rogan has espoused that he  doesn’t feel the need to receive the vaccine as he has an immune system that is strong (Where have I heard that before?). However, in September Rogan admitted that he has COVID but feels great.  Rogan also admitted that he took Ivermectin to combat the COVID , all be it was the human dosage of Ivermectin despite the horrible reporting of CNN.

To reiterate, we all have immune systems and certainly some better than others but when we have cases of marathon runners having trouble walking up a flight of stairs, or professional athletes not able to perform normal tasks for a period I am concerned.  Also a statement about having a strong immune system sounds great for you, but what about the other people around us?  Do you care about those people?  I am sure Joe Rogan has a great immune system, and I am sure he thinks Ivermectin gave him that superpower.  In actuality, Ivermectin has been studied to determine it’s affect to COVID 19.  In a 2020 paper, Ivermectin a docking study was performed to determine if Ivermectin could dock to the SARS-CoV-2 spike receptor-binding domain.  The conclusion was that ivermectin could interfere with the attachment of the COVID spike protein to human cells.  There goes Ivermectin blocking stuff again.  Due to this possibility, Ivermectin is currently being used in clinical studies to determine it’s effectiveness at treating COVID.  Based on the current evidence, the completed studies Ivermectin shows little to no evidence of being able to adequately treat COVID and reduce symptoms.  SHOCKER!!!!   But, like most things in science new data can lead to new possibilities.

Even though some of the information that Joe Rogan states is not factually correct or coming from a place not rooted in science, many people are subsequently influenced accordingly.  Social commentators and contrarians can often gain a platform and following far easier than someone who states concise facts.  Exhibit A: Aaron Rodgers, who represents the people (+ the money) that consult from social commentators instead of doctors.  (Ya dun messed up A-a-ron).  Aaron Rodgers certainly was not forthright about his vaccine status but to me the acknowledgement of consulting with Joe Rogan on Ivermectin instead of a doctor is troubling, but a symptom of what certainly seems to be a trending distrust of the Medical field.

So, lets examine the distrust in the Medical field particularly in 2020.  I would be remised if I didn’t mention the omnipresence of QANON.  Qanon (Q), is what started out as a fringe group in the United states with conspiratorial ideas that quickly became maintain stream over the past few of years.  One of the ideas that spawned was that the COVID vaccine was a scheme for the elite to track us.  If you have a phone or use Google, trust me you are already being tracked.  Many people, and let’s face it disenfranchised people have felt a disconnect to the people who seem to have much influence, power, money in their community.  The scientific and medical community can in some ways appear to be apart of that elite community (although my student loans say otherwise).  In 2020 while the COVID virus was ravaging the globe, coupled with a huge divide between the have and have nots, and mistrust of the scientific and medical community; what will a disenfranchised person to do?

Finally, I think there is another uniquely developed world behavior that may play a role in the rise of Ivermectin.  Growing up Robitussin AKA Tussin, Peptobismol, and Tylenol were common household medicines that we used to treat common ailments.  In the wise words of Chris Rock, “put some Tussin on  it” was panacea for most ailments.  If you had a stomach ache take some Peptobismol, and if your head hurts take a Tylenol and get out there buddy.  (looking at you coach).  This type of psychology can get ingrained into your subconscious, and as adults we still tend to look for pill to cure us of our ailment almost instantaneously.

Conclusion

As you can see Ivermectin is a viable prescription drug to treat certain parasitic infections.  Due to its mechanism of action it may potentially have the ability to treat COVID-19, but like many things in science additional information and testing is needed to confirm it.  However, the current political, economic, and social climate has truly affected how this drug is perceived and being used.  Sometimes to disastrous effect.  If we want really stop this type of use we as scientists and medical professionals have to come to terms with the why.  Why is there such mistrust and talk to people on a human level so trust can be regained.  And hopefully we all look to Joe Rogan for his entertaining bantor and UFC commentary