Gut Health & Parasite Education

How to Get Rid of Parasites from Sushi

Yes, you can get worms from raw fish. And yes, traditional Japanese cuisine already figured out the botanical answer — millennia before anyone called it a parasite cleanse.

By Brehan Crawford, MAcOM, LAc

Let me be direct with you, the same way I am in every video: I have spent years debunking the online parasite-cleansing industry. The glitter-bomb laxatives, the 30-day rope-worm protocols, the influencer kits promising to purge everything mysterious from your gut, none of that is grounded in solid evidence, and plenty of it is actually harmful.

But here is the thing. While the internet is selling you $89 "parasite cleanse" bundles, traditional Japanese cuisine has quietly been deploying real, research-backed antimicrobial and antiparasitic plant medicine on every sushi platter for centuries. I'm talking about shiso leaf, ginger, and wasabi, the trio of botanicals most Western diners either ignore or trade for the plastic decorative version.

This post is my love letter to traditional food wisdom and a gentle public service announcement for anyone eating raw fish without these plants on the side. It is also a reminder that herbal medicine is sophisticated, not trendy. And that real parasite protection does not come in a 30-capsule kit sold by a wellness influencer.

"Traditional Japanese sushi accompaniments are not garnishes. They are a complete botanical defense system developed across centuries of empirical medicine."

— Brehan Crawford, MAcOM, LAc

First, Let's Talk About Anisakis — The Worm You Actually Need to Know About

Anisakis is a genus of parasitic roundworms with a life cycle that runs through fish and marine mammals. When you eat raw or undercooked fish — salmon, mackerel, herring, squid, anchovies you can ingest third-stage larvae that are perfectly capable of embedding in your gastrointestinal tract. The resulting condition, anisakiasis, can cause severe abdominal pain, nausea, and vomiting within hours of ingestion, and can occasionally require endoscopic or surgical removal.

This is not a fringe risk. A 2020 systematic review found Anisakis larvae in fish sourced globally, with rising incidence directly correlating to the growing international popularity of raw fish cuisine. The FDA's primary recommendation for preventing foodborne illness is freezing fish before serving it raw — and reputable sushi establishments follow this protocol. But what if your raw fish experience goes beyond restaurant dining? What if you're fishing, preparing your own sashimi, or eating at a place without strict cold-chain protocols?

This is exactly where traditional botanical food medicine enters the picture — and where the science gets genuinely interesting.

The Three Botanical Allies on Your Sushi Plate

"Ecology over warfare. You are not trying to obliterate every organism in your gut — you are creating conditions where pathogens cannot thrive. That is what traditional food medicine does."

— Brehan Crawford, MAcOM, LAc

Why I Keep Debunking Online Parasite Cleanses

I want to be crystal clear: I am not anti-herbal medicine. I am a practitioner of herbal medicine. What I am against is the unregulated, misrepresented, fear-based parasite cleanse industry that has taken genuine botanical science and turned it into something I can only describe as glamorized laxatives.

Most online parasite cleanses are built around herbs like black walnut hull, cloves, and wormwood, which do have real antiparasitic properties in a clinical context. The problem is dosing, sourcing, formulation, duration, and indication. These herbs at the doses sold in typical online kits are unlikely to reach therapeutic antiparasitic concentrations. At higher doses, some of them are genuinely toxic. And the "rope worms" and "biofilm ropes" people photograph after doing these cleanses? That's intestinal mucus and undigested fiber. It's not a parasite.

If you suspect you have a real parasitic infection — actual clinical symptoms, potential exposure through travel or raw food, something that showed up on stool testing — please work with a qualified provider. A physician can test for actual parasites and, if confirmed, prescribe antiparasitic medications that work reliably and quickly. If those medications don't work, or if you have side effects, that is when clinical herbal medicine becomes genuinely valuable — and that is exactly the work I do.

The plants in your sushi are not a cleanse. They are daily, cumulative, intelligent botanical protection — the kind that has been tested not in clinical trials but in the long, slow laboratory of human civilization. And that, to me, is worth more than a 30-day kit with a celebrity endorsement.

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When to Actually See a Physician

I said it in the video and I'll say it again: if you genuinely think you have a parasitic infection — if the video reached you after the sashimi, not before — please see a physician. Antiparasitic medications are effective. Albendazole, mebendazole, ivermectin — these drugs work reliably for most common worm infections, and you should take them if your provider confirms you need them.

If the drugs don't fully work. If you have ongoing gastrointestinal symptoms post-treatment. If you experience side effects that affect your quality of life. If you live with chronic gut dysfunction that conventional gastroenterology hasn't resolved — that is where clinical herbal medicine excels, and that is where I would love to support you.

This is not about choosing between conventional medicine and herbal medicine. This is about knowing which tool fits the job. Acute infection? Go to your doctor. Long-term terrain restoration? Let's talk about plants.

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References & Further Reading

1. He W, et al. (2020). Antimicrobial activity and mechanism of action of Perilla essential oil against Staphylococcus aureus. E3S Web of Conferences, 145, 01015. Read Paper
2. Kiambom T, et al. (2021). In Vivo Anthelmintic Effect of Ginger (Zingiber officinale) Powder against Gastrointestinal Nematodes of Artificially Infected Pigs. Archives of Veterinary Science and Medicine, 4(1): 1–12. DOI: 10.26502/avsm.020. Read Paper
3. Rahmati AR, et al. (2020). Nematocidal activity of wasabi paste and allyl isothiocyanate against Anisakis third-stage larvae and their stress response characterized by heat shock protein expression. Journal of Helminthology (Cambridge University Press). Read Abstract
4. Iqbal Z, et al. (2006). In vivo anthelmintic activity of ginger against gastrointestinal nematodes of sheep. Journal of Ethnopharmacology, 106, 285–287. PubMed
5. Lin RJ, et al. (2014). Anthelmintic constituents from ginger (Zingiber officinale) against Hymenolepis nana. Acta Tropica, 140, 36–45. PubMed
6. Rahmati AR, et al. (2020). World-wide prevalence of Anisakis larvae in fish and its relationship to human allergic anisakiasis: a systematic review. Parasitology Research, 119, 3585–3594