fmt: the new frontier in the war against depression, obesity, and chronic illness

FECAL MICROBIOTA TRANSPLANT
THE NEW FRONTIER IN THE WAR AGAINST DIABETES, OBESITY, DEPRESSION, AND AUTOIMMUNE DISEASES

Fecal Microbiota Transplant

Darwin Laganzon (Typographyimages) – Pateros/Philippines – Pixabay

“A microbiome is “the ecological community of commensal, symbiotic, and pathogenic microorganisms that literally share our body space.”  From the December 2009 issue of the medical journal Genome Research (The NIH Human Microbiome Project)

We are born into a world of alien and unseen creatures found in numbers beyond comprehension.  These are the bacteria that grow on our SKIN, and colonize our digestive tracts.  We get (or should get) our first dose of beneficial bacteria as we travel through the birth canal (HERE).  And as long as we are not pathologically clean (HERE and HERE), these bacteria will usually grow and thrive.  This is a good thing because I am beginning to believe that your microbiome is the most important predictor of whether you will be healthy or sick, fat or thin, depressed or happy, etc, etc, etc.  

Unfortunately, there are a wide range of things that foul up or even destroy our microbiomes.   Some of the most obvious are ANTIBIOTICS as well as NON-ANTIBIOTIC DRUGS.  But you can’t forget to mention things like antimicrobial soaps and other hygiene products, HALIDES (Fluoride and Chlorine), chemical exposure of all kinds (HERE is one example), diets high in SUGAR or refined carbs and low in FIBER, as well as CHRONIC STRESS or sub-clinical infections.  GLUTEN can be a major player as well due to its strong link to both AUTOIMMUNE DISEASES and LEAKY GUT SYNDROME.

When you look at our nation’s explosion of CHRONIC INFLAMMATORY ILLNESSES & AUTOIMMUNE DISEASES (click for lists of each), and compare it to the peer-reviewed research coming out of the field of GUT HEALTH, it doesn’t take a rocket scientist to see where we are screwing up.  Not only are we not feeding our Guts the proper Prebiotic nutrition (the topic of my next post), we are eating really crappy diets in general.  And when you look at my list in the previous paragraph, it’s not difficult to make the case that we are doing everything in our power to destroy our biggest ally in the battle for good health — our own God-given bacteria — our microbiome (HERE is an example).

You see, not only do bacteria make up 80% OF YOUR IMMUNE SYSTEM, but they perform any number of other critical physiological functions as well (HERE).  When health problems are severe, the odds increase that you will not be able to resolve them by simply taking probiotics — or even “poop pills” (HERE or HERE).  Don’t get me wrong; PROBIOTICS can be a Godsend for people dealing with any number of health issues (HERE), but the fact remains that FMT (Fecal Material Transplants) are the new frontier of real health care.  Think I’ exaggerating?  Listen to what some of the world’s leading experts on the subject have to say.  But before I do this, let’s clear the air.

Because the FDA has all but totally shut down FMT’s for anyone other than those who have had multiple C. DIFF infections, they are looking elsewhere.  They are looking to any number of the DIY internet sites to, well; figure out what it will take to do it themselves.  Am I suggesting that you look into this option?  Even though I have shown you DIY FMT VIDEOS in the past, I am not even for one moment advocating for you to do an FMT.  As always, your health and what you do about it is completely up to you.

For the record, the information on this website and / or post is not to be construed as medical advice.  All of it, including text, images, and videos are for ‘informational’ purposes only. The purpose of this site is to promote a broader public interest, understanding, and knowledge of a wide range of health-related topics (including Gut Health and Fecal Microbiota Transplants). Neither this site nor the information contained in it is intended to provide a substitute for professional medical advice, medical diagnosis, or medical treatment. Always seek the advice of your physician before asking, doing, feeling, or even thinking about anything that pertains to your health. 
 

“FMT is also being considered as a treatment for inflammatory bowel disease, obesity, and other disorders…..”   From the FDA’s Vaccines, Blood & Biologics page (Public Workshop: Fecal Microbiota for Transplantation).

Mayo Clinic in Arizona has performed 24 fecal microbiota transplants for CDI patients. In every case, the infection was completely eradicated — often within hours or days…..   The beauty of the procedure is that even when patients have an ongoing disease process, their quality of life is tremendously improved after the transplant…   The sky is the limit.  Its use in C. difficile has been well established…  Some physicians claim to have great success treating ulcerative colitis and celiac disease. And it’s been looked at for obesity, diabetes and rheumatoid arthritis….”   Cherry-picked from the “For Medical Professionals” section of the Mayo Clinic’s website (Quick, Inexpensive and a 90 Percent Cure Rate).

“Fecal Microbiota Transplantation (FMT) has been used sporadically across Europe, North America and Australia for over 50 years.  In the past six decades, our gut microbes have been under assault from antibiotics in the form of medical therapy and farming practices. The concerns over potential unanticipated health consequences are only now beginning to be realized, with multiple diseases associated with the current Western lifestyle hypothesized as being causally linked to alterations in the gut microbiota.  Examples include constipation, irritable bowel syndrome, inflammatory bowel disease, neurological diseases, cardiovascular diseases, obesity, metabolic syndrome, autoimmunity, asthma, and allergic diseases, many of which have reached epidemic proportions in recent years.”  From a scientific abstract by the modern “father” of FMT, Dr. Thomas B Borody of Sydney, Australia and colleague, Dr. Alexander Khoruts of Minneapolis (Fecal Microbiota Transplantation and Emerging Applications).

GI-linked diseases, such as obesity, metabolic syndrome and diabetes mellitus may be treated by FMT in the future. FMT has produced isolated case responses in patients with multiple sclerosis, Parkinson’s disease, chronic fatigue syndrome and idiopathic thrombocytopenic purpure.  After FMT, rheumatoid arthritis, sacroileitis, halitosis, acne, insomnia and major depression have shown improvement. Autism spectrum disorder is another condition in which FMT may offer a clinical role.”  Dr. Nathan Connelly of the Moonee Valley Specialist Centre for Gastroenterological and Related Care near Melbourne, Australia

“Although the most common application for FMT has been in the setting of recurrent CDI [C. Diff Infection], there is ongoing research to assess benefit in other gastrointestinal diseases. These include inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and chronic constipation. There are also isolated reports of FMT effects in nongastrointestinal disease, including multiple sclerosis and Parkinson’s disease.”  From a 2013 issue of Expert Review of Gastroenterology and Hepatology (Alteration of the Intestinal Microbiome Fecal Microbiota Transplant and Probiotics for Clostridium Difficile and Beyond).

“Other disease states that are closely linked to the GI microbiota, such as obesity, metabolic syndrome, and diabetes mellitus, may potentially be treated by FMT in the future.   Isolated case reports of FMT response include multiple sclerosis, Parkinson’s disease, chronic fatigue syndrome, and idiopathic thrombocytopenic purpura.   Apart from these published reports, the lead author has also observed convincing improvement after FMT in several other conditions, including rheumatoid arthritis, sacroileitis, halitosis, acne, insomnia, and major depression. Autism spectrum disorder is another condition in which the GI microbiota is implicated, where FMT may have a role.”  From a 2013 issue of Current Gastroenterology Reports (Fecal Microbiota Transplantation: Indications, Methods, Evidence, and Future Directions).

All I can say is wow!  Look at the wide range of diseases mentioned.  Some of these are of particular interest because they are known to run in my family (PARKINSON’S for instance).   HERE and HERE are a couple articles I wrote pertaining to Rheumatoid Arthritis and FMT as well.  The bottom line is that if you or a loved one is dealing with Chronic Illness, you need to keep reading.

FMT FOR DIABETES AND OBESITY

FMT Obesity

Wellcome Trust # V0010868

Because DIABETES (METABOLIC SYNDROME included) and OBESITY are so closely related to each other, for this post we are covering them as a single entity. This triad is so common that it is often referred to as “Diabesity”.  Remember back to the conclusion we saw a few paragraphs ago revealing that Depression was related to Gut bacteria regardless of other factors?  The same thing could probably be said of Obesity. 

A 2006 study done at St. Louis’ Washington University (the Harvard of the Midwest) and published in the December issue of the journal Nature was one of the first studies that shed light on this topic.  Without going into detail, I will leave you with the study’s (Microbial Ecology: Human Gut Microbes Associated with Obesity) conclusion.  “Our findings indicate that obesity has a microbial component, which might have potential therapeutic implications.”  In other words, your microbiome is related to your weight.  The same issue carried another study (Physiology: Obesity and Gut Flora) with a similarly short conclusion.  “The intestinal bacteria in obese humans and mice differ from those in lean individuals.”  In both of these studies we see the weight of mice being manipulated not so much by what they eat, but by the makeup of their Gut bacteria.  You’ll better understand what I am talking about momentarily.

A 2010 collaboration between Emory University, Cornell University, and the University of Colorado was published in the April 2010 issue of Science (Metabolic Syndrome and Altered Gut Microbiota in Mice Lacking Toll-Like Receptor 5).  The abstract stated that, “Metabolic Syndrome is a group of obesity-related metabolic abnormalities that increase an individual’s risk of developing type 2 diabetes and cardiovascular disease. Here, we show that mice genetically deficient in Toll-like receptor 5 (TLR5), a component of the innate immune system that is expressed in the gut mucosa and that helps defend against infection, exhibit hyperphagia [extreme hunger] and develop hallmark features of metabolic syndrome, including hyperlipidemia [high levels of fat in the blood], hypertension [high blood pressure], insulin resistance, and increased adiposity [high body fat]. These metabolic changes correlated with changes in the composition of the gut microbiota.  Transfer of the gut microbiota from TLR5-deficient mice to wild-type germ-free mice conferred many features of metabolic syndrome to the recipients. Food restriction prevented obesity, but not insulin resistance, in the TLR5-deficient mice. These results support the emerging view that the gut microbiota contributes to metabolic disease…..

This study revealed how TLR5 helps keep DYSBIOIS in check.  In other words, it helps keep the bad bacteria from taking over the Gut and crowding the good bacteria out.  Not enough TLR5, and bad bacteria will mutiny and eventually gain control.   Not surprisingly, this study showed that the mice without TLR5 were overweight / obese, ate more, had Metabolic Syndrome / Insulin Resistance, and Fatty Liver (FYI: the most common cause of a Fatty Liver is Obesity), which was determined to have been brought on by CHRONIC INFLAMMATION.  The absolutely insane part of this study was that when feces was transferred from one group to the other, the mice in either group took on the characteristics of the mice whose feces was transplanted.  This was true in either direction.

Another 2010 study (Metabolic Effects of Transplanting Gut Microbiota from Lean Donors to Subjects with Metabolic Syndrome) collaborated on by over a dozen doctors / researchers from some of the most prestigious institutions in Europe came to some interesting conclusions of their own.  “Recent data in animal models revealed that obesity is associated with substantial changes in composition and metabolic function of gut microbiota.  Lean donor faecal infusion improves hepatic and peripheral insulin resistance as well as fasting lipid levels in obese individuals with the metabolic syndrome underscoring the potential role of gut microbiota in the disturbances of glucose and lipid metabolism in obesity.”  This should pique the interest of Americans, considering that METABOLIC SYNDROME is the precursor to full-blown DIABETES, and to merely call either an ‘epidemic’ would be dramatically understating the problem.

Medscape’s website carries a section called Current Opinion in Gastroenterology: Fecal Microbiota Transplantation.  Filed under Treatment of Nongastrointestinal Diseases: Obesity, we find the following.    One double-blinded, controlled trial randomized 18 men with metabolic syndrome to FMT using their own feces or feces donated from lean men. The nine men who received stool from lean donors developed markedly reduced fasting triglyceride levels and peripheral and hepatic insulin sensitivity after FMT compared with those who were transplanted with their own (placebo) stool.”   In other words, we are learning that what is true in mice, is likewise true in humans.

Oh; and let’s not forget the study I showed you a couple of years ago about GASTRIC BYPASS.  In this study, we saw that Gastric Bypass Surgeries might not be anything other than an invasive (and expensive) method of transplanting healthy bacteria into a sick Gut.  But should we be surprised; particularly after learning that Antibiotics given to infants or children have been shown to cause Obesity later in life (HERE)?  And let’s not forget the study that clenches it for me.  Although we’ve known it to be true for several years, we RECENTLY LEARNED why diet soda makes people fatter than if they drink regular soda.  It’s simply because ASPARTAME destroys the Gut’s normal flora.  And the research just keeps coming

Just last month there was a Chinese study published in the medical journal Nutrients called Obesity: Pathophysiology and Intervention.  It stated that (I’m cherry-picking here)  “Obesity presents a major health hazard of the 21st century. It promotes co-morbid diseases such as heart disease, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis. Fecal microbiota transplantation (FMT), infusion of a fecal suspension from a healthy individual into the gastrointestinal (GI) tract of another person, has been used successfully not only for alleviating recurrent Clostridium difficile infection, but also for GI and non-GI-related diseases such as obesity.  New therapeutic strategies have become available for managing obesity apart from the standard protocol of diet and/or exercise. These include anti-obesity drugs, various bariatric surgical procedures, and FMT.”   I’ve already talked about the Bariatric Surgeries, and as for the drugs; if they worked well (how about if they worked at all) or weren’t incredibly dangerous and addictive, you would actually hear something about them (HERE). 

It is my opinion that FMT is the new frontier as far as Diabetes / Insulin Resistance / Metabolic Syndrome / Obesity is concerned.  All you really have to do is to look at some of the studies on the subject to see that FMT is, at the very least, something to look into —- a potential option for helping those struggling with obesity.

FMT FOR ANXIETY AND DEPRESSION

Fecal Microbiota Transplant

Waldkunst – Schweiz – Pixabay

All sorts of mental / brain issues from Anxiety, to DEPRESSION, to Bi-polar Disease, to ADHD / ADD, to SCHIZOPHRENIA, and numerous others have been traced back to a fouled up microbiome.  Even AUTISM is being touted as a soured microbiome, often caused by VACCINES (HERE). When you add all of this together, it means that there is at least anecdotal evidence that FMT could be of benefit for this family of problems. 

It’s not news that there is a strong link between the Gut and the Brain. In fact, the link is so strong that the Gut is often referred to as “THE SECOND BRAIN“.  In the September 2013 issue of Psychology Today, Dr. Dale Archer (a psychiatrist) wrote an article called Gut Bacteria Transplant: A New Treatment For Anxiety?  Listen to what he writes.  “Recent scientific studies indicate that gut bacteria may play a pivotal role in brain chemistry and mental health. More specifically, the right type of “healthy bacteria” in your gut may treat/prevent depression and anxiety.  In research circles the gut is often referred to as the “second brain“.  There are over 100 million neurons in the gut (more than the spinal cord or peripheral nervous system) and many contain the exact same neurotransmitters as the brain.” 

This is not surprising considering that I showed you HERE that, “Serotonin is a neurotransmitter that is made largely (90%) in the gut If you do not understand this simple fact, you cannot help yourself kick Depression without drugs!”   If you are looking for a bit more information on the wide array of functions related to the bacteria that live in your digestive tract, try THIS POST.  Oh, and for those who are not aware, there is actually a great deal of research being done in this area. 

For instance, in a 2011 study done at UCLA and published in that August’s issue of Gastroenterology (The intestinal Microbiota Affect Central Levels of Brain-Derived Neurotropic Factor and Behavior in Mice), we learned some interesting facts in regards to FMT and its ability to change brain function.  In this study, two distinct groups of mice were looked at — calm and anxious.  Remember how scientists were able to make fat mice thin and thin mice fat, simply by transplanting ‘stool’ from one group to the other?

In this particular study, the calm group was made anxious when the feces from the other group was transplanted into them, and vice versa.  Listen to this study’s amazing conclusions.  “The intestinal microbiota influences brain chemistry and behavior independently of the autonomic nervous system, gastrointestinal-specific neurotransmitters, or inflammation. Intestinal dysbiosis might contribute to psychiatric disorders in patients with bowel disorders.”  Dysbiosis (a fouled up microbiome) might contribute to psychiatric disorders. 

In a similar study published in the September 2013 issue of Neurogastroenterolgy and Motility (Melancholic Microbes: A Link Between Gut Microbiota and Depression?) researchers from USC and the University of Cork in Ireland went even further when they wrote that, “There is a growing awareness of the potential for microbiota to influence gut-brain communication in health and disease. A variety of strategies have been used to study the impact of the microbiota on brain function and these include antibiotic use, probiotic treatments, fecal microbiota transplantation, gastrointestinal infection studies, and germ-free studies. All of these approaches provide evidence to support the view that the microbiota can influence brain chemistry and consequently behavior.  Animal models of depression are thus essential in studying the complex interplay between the microbiota and brain. Recent studies published in this Journal and elsewhere demonstrate that there is a distinct perturbation of the composition of gut microbiota in animal models of depression and chronic stress.  Moreover, given that affective co-morbidities, such as major depression and anxiety states, are common in patients presenting with irritable bowel syndrome (IBS), it may have implications for functional bowel disorders also.

As these statements reveal, there is a strong link between IBS (which is frequently a component of FIBROMYALGIA) and Anxiety / Depression (HERE is an article I wrote showing the link between childhood abdominal pain and adult Depression).  So; even if there are not yet enough studies to force the FDA to take another look at FMT for brain-based problems (including SYMPATHETIC DOMINANCE), there is certainly enough evidence to make sufferers take a second look.  Probably why the DIY FMT’S.

IS FMT SAFE?

Although I found several studies warning of at least a potential temporary increase in IBS-like symptoms, the most common statement of safety I found (in multiple places) was that there has never been a death or serious ADVERSE EVENT tied to FMT.  

In a March 2012 interview for the journal Gastroenterology & Hepatology (Fecal Transplantation for the Treatment of Clostridium difficile Infection), Dr. Lawrence Brandt, one of the world’s foremost experts on FMT, had this to say on the safety of FMT in general.    “At present, I do not think there are any patients in whom fecal transplantation is contraindicated. I have performed several fecal transplantations in immuno-compromised patients without adverse effects. Fecal transplantation therapy is a safe, highly effective, and simple technique that has very few downsides.”  But the same time Dr. Brandt was giving his opinion, Dr. Mark Crislip was giving his.

The website Science-Based Medicine fancies itself as the defender / protector of “EVIDENCE-BASED MEDICINE“.  It’s authors are also on an active crusade against virtually any form of holistic or natural healing (HERE and HERE are a couple of articles I wrote about their site).  Dr. Crislip, a specialist in Infectious Diseases, wrote in a March 2012 article called Species in the Feces that, “Under normal circumstances, when it comes to the colon it is probably better to be removing substances than to be introducing them.”  Furthermore, after picking apart an article touting FMT, “for other health problems, including autoimmune disease, eczema, asthma, multiple sclerosis and depression… and improved mood,” he went even further.  Listen to the arrogance in this next statement. 

To say there is even biologic plausibility to treating MS or depression with stool transplants requires a biology I was never taught and cannot imagine. The opportunity for placebo effects to predominate with stool transplant would be enormous. But there are those who, well, like that sort of thing.  To each their own.  For diseases outside the colon, biologic plausibility makes stool transplant unlikely to have any benefit with real potential downsides.  Stool transplants are unlikely to be of widespread to benefit,  but when all you have to offer is crap, everything is a toilet.”  

Am I missing something here?  Everything on his little list is considered to be at least to a large degree, caused by Inflammation.  That Inflammation and the microbiome are intimately intertwined together is not new information.  In fact, it’s one of the hottest areas of current medical research.  I have written posts on everything he lists and can unequivocally tell you that everything he mentions is directly related to Gut Bacteria (or lack thereof) in the peer-reviewed literature (ASTHMA, MS, and DEPRESSION — the others can be found elsewhere within this post).  The point of bringing this up is not to personally pick on Dr. Crislip, but to show you how the average doctor thinks.  Since he didn’t learn it in school (he graduated in the late 80’s), therefore it doesn’t exist.   Sounds like another version of the “Ostrich Game” to me.

How does the average doctor think?  They are often times so far behind the current research that what they are doing in clinical practice was obsolete a decade or more ago (OVERUSE OF ANTIBIOTICS is a prime example — my site is full of others).  That something (FMT) with so much “evidence” can be maligned as “implausible” is absurd in this day and age — particularly when all one has to do is jump on PubMed and start looking at the studies for yourself.  I’ve warned you before, but it’s critical to realize that the gap between medical research and medical practice can sometimes make the Grand Canyon look like a ditch (HERE).   Just understand that this is why talking to your doctor about FMT — while I certainly recommend the conversation — is not likely to bear much fruit. 

FMT has been around, at least in some capacity, since the late 1950’s and was discussed in the journal Surgery back in 1958.  There’s even evidence that it was being used in antiquity within the parameters of Chinese Medicine.  It is my opinion that if you can find a healthy donor (if you’re not sure, screen them with the test found on THIS LINK), the sky is the limit.  Without a doubt, talk to your doctor, but do your own research as well.  The internet is an ocean of information that I hope I made a bit easier for you to navigate.

Oh, and if you decide to do an Fecal Material Transplant, beyond finding the best donor possible, you’ll need to make some lifestyle changes.  HERE are a few.  You may be excited about the prospect of finding a solution, but if you go on doing the same old things and living your life the same old way, it won’t be long before you foul up your new microbiome like you fouled up your old one. 

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