People all over the world have started swallowing worms, and not because anybody dared them to do it. Now, according to Discover magazine, Germany may become one of the first countries to legalize this controversial treatment.

It’s called helminthic therapy: an intentional parasite infection that (theoretically) suppresses an overactive immune system.

For reasons scientists don’t fully understand, autoimmune and inflammatory conditions like asthma, lupus, and inflammatory bowel disease are on the rise. Yet despite their prevalence, treatment options for some of these conditions are slim. After years of illness, many people reach a point where they’re willing to try anything; one study estimates that more than 7000 people have purchased parasites online to try at home.

Trials of the treatment have had mixed results. Some studies found that helminthic therapy may help people with Crohn’s disease, celiac disease, and multiple sclerosis. Its efficacy in other conditions, like allergies, is less clear.

The U.S. Food and Drug Administration has classified helminthic therapy as an Investigational New Drug (IND). This means it can only legally be used by researchers in clinical trials. But just across the border in Mexico, there are providers and clinics specializing in the parasite treatment. Thailand has legalized helminthic therapy, too. Elsewhere, would-be consumers are out of luck.

That may soon change, as Germany’s Federal Office for Consumer Protection and Food Safety is currently considering allowing the use of a parasite called Trichuris suis. If the certification is approved [PDF], a liquid containing the worm’s eggs will be certified as a food ingredient. This particular species ordinarily infects pigs, and is short-lived in humans, a fact that proponents say should reduce or eliminate the risk of side effects.

Even if the government says helminthic therapy is safe, experts recommend using it like any other drug—that is, with medical supervision.

“Self-medication with any type of worm is not recommended,” Helena Helmby of the London School of Hygiene and Tropical Medicine told New Scientist, “and it is important to remember they’re not in any way completely harmless, and may cause quite severe side effects if not monitored very carefully by a doctor.”

[h/t Discover]