Article The Poop Broker. Michael Harrop started a booming underground market for human feces. But something smells off about his product. (May 2024, Slate)

[Michael Harrop]

https://slate.com/life/2024/05/fecal-transplant-fmt-c-diff-microbiome-poop-black-market.html

Kind of an odd article. Amusing, seemingly agenda-driven, occasionally deceptive, but not all bad. I'm curious what impact this article will have. Will it be better or worse than the "complete silence" by most of the media up until now?

The journalist interviewed all of our recipients who volunteered to be interviewed. I think there were a dozen or so, and they included a doctor and other people with advanced biology degrees. The goal may have been to find dirt to dig up, but they didn't find any. But in many places, the article is worded as a hit piece that seems like it would have been much worse had there been any actual "dirt".

Is HumanMicrobes.org really "the black market for poop"? I don't see it that way at all. Grey market perhaps, but a "market" isn't my goal regardless. And it's certainly not "booming".

Anyone unfamiliar should review our website and blog https://www.humanmicrobes.org/blog which lays out all the details. This 10 minute Youtube video gives an introduction to the project as well: https://www.youtube.com/watch?v=6wi52tLjCps

I can only guess that Slate felt that writing this type of article would attract more clicks. So we continue on the path that there's a possible solution to rampant chronic disease and a single disabled person remains the only one out of billions of people who is trying to obtain it.

nor did he offer me a detailed personal biography when I reached him over the phone

Contradicted by the very next paragraph where he quotes me giving a detailed personal biography.

Harrop refers to the website as a business and his primary commercial enterprise.

I would have never used that wording. In fact, when starting out I explicitly said that I didn't consider it a business and wasn't interested in starting a business. But at this point, "a business" seems accurate.

The poop he sells costs around $1,000 per “dose,”

It's $1,000 for a whole stool split into 10 pieces/doses. So $100 per dose, for anyone able to do some basic kindergarten math.

This is a standard echoed by some of the more aboveboard FMT distributors

It's not. Openbiome touts a pass rate of 3%, which is not close to "fewer than 0.1%". Openbiome, and other "aboveboard" FMT distributors all have severe donor quality deficiencies, which is why the humanmicrobes.org project had to be started to begin with. Of course, this was not mentioned at all in the article. Later on, the article does mention:

two people died and four more became ill after receiving stool supplied by OpenBiome during clinical FMT trials.

the stool used in the trial was improperly screened

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he and the HumanMicrobes community will divide the cost for them to receive a fecal test from a doctor to screen for “a handful of known pathogens.”

This is deliberately deceptive. The tests that are done are from the European consensus conference on faecal microbiota transplantation in clinical practice https://gut.bmj.com/content/66/4/569#boxed-text-3. So our testing is equal to the most rigorous testing, and is according to an international scientific consensus published in a reputable scientific/medical journal. "A handful of known pathogens" is me describing the severe limitations of current testing capabilities, which I provided citations for (https://humanmicrobiome.info/testing/), and which highlights the importance of our other screening criteria (such as stool type).

They reference the wiki (https://humanmicrobiome.info/) without linking to it. Likely because people who actually review it will recognize it as a high-quality, scientific resource which goes against the tone of the article.

Naturally, doctors firmly reject Harrop’s operation.

Strange then that so many doctors, other medical personnel, and people with advanced science degrees, are all applying to be donors as well as purchasing from our donors. The Slate journalist who wrote the piece even interviewed some of our recipients who were doctors and other bio degree holders.

FYI, Sahil Khanna, the Gastroenterologist they interview and quote, is hired by many pharmaceutical companies:

Sahil Khanna has received grants or contracts from Rebiotix (a Ferring company), Finch Therapeutics, Seres Therapeutics, and Vedanta BioSciences, consulting fees from Niche Pharmaceuticals and Immuron Limited, participated on advisory or data safety monitoring boards for Ferring Pharmaceuticals, and has stock options with Jetson Probiotics. https://pubmed.ncbi.nlm.nih.gov/36287379/ - as of 2022.

This includes the developers of the $17,500 per course "FMT alternative" drug that was recently FDA-approved. Companies like that may see FMT and the Human Microbes project as threats to their profit.

Despite that, I'm still doubtful that Sahil Khanna thinks the humanmicrobes.org project is "a terrible idea".

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But it does make you wonder if, say, 50 years from now when more research has been done, ardent FMT proselytizers like Harrop will be somewhat vindicated

It would be extremely dystopian if that took yet another 50 years when it very likely already exists and is extremely simple.

Not to mention that the "more research" they reference is literally impossible without the humanmicrobes.org project screening millions of people to find high-quality donors: https://www.humanmicrobes.org/blog/fda-fmt-regulation

What if there is a miracle drug waiting for us in the right toilet?

Indeed. What does this article do to advance the process of finding out whether or not that's the case? One might argue that this article hinders the most promising effort to discover it.

 

[Michael Harrop]

I was thinking about this in the context of the media always complaining that they're dying and can't afford to fund themselves.

For the past two days there have been dozens of articles in my news feed covering the same trivial story about one person doing DIY FMT from their boyfriend. Somehow that's more newsworthy than hundreds of Human Microbes recipients doing FMT, and HM screening 1.2 million people to try to find a super-donor.

A 2019 South Park episode is still the best piece of journalism that's been done on this topic. How ridiculous is that? One of the largest and likely most important public health projects in human history has not been covered by major news media for 5+ years. The media seems to be completely at fault for their own predicament.

Last year I signed up for the LA Times because I wanted local news, and their content was terrible compared to free news aggregation & discussion sites.

 

[Fmt2024]

This is so confusing. They unfairly criticize an organization that has the opportunity to help so many desperate people with their chronic illnesses then conclude the article with a positive testimonial lol.

 

[Michael Harrop]

Yeah it was an odd article. There were so many other interesting things that could have been covered. For example, the journalist noticed a trend of most recipients ordering FMT due to being harmed by antibiotics. I mentioned to the journalist that there are lots of laypeople who exhibit hostile reactions when studies are shared that cover the harms/collateral damage of antibiotics, and they equate it with being "anti-vax".

From my discussion with him:

I find it extremely bizarre that there's this huge anti-vaccine movement when the scientific consensus is overwhelmingly in favor of vaccines, and yet there's no anti-antibiotic movement despite there being a strong consensus of their long-term damage https://humanmicrobiome.info/antibiotics/.

And when the downsides of antibiotics are covered in the news, 99% of the time it's only about resistance, and collateral damage is ignored. That's also the case for many of the official antibiotic guidelines -- they do not take collateral damage into account at all, thus making the guidelines far too lenient.

I just commented on this to the FDA after another patient reminded me that they needed FMT due to being harmed by antibiotics:

You have approved other products that are far more risky and harmful than any of our donors. Many of us are in fact needing FMT to reverse the damage from these other products that you approved. These products do not come with relevant warnings that resulted in informed consent when we took them. https://humanmicrobiome.info/antibiotics/

And by preventing us from accessing FMT, they're preventing us from being able to access the only intervention that can reverse the damage that was done to us.

 

[ItsJustAPhageMom]

Many of these are publicly traded companies. So it's not just "big pharma" who's against you; it's all the thousands of people who've invested in the companies. That "50 years" comment is them saying "Please don't do this for another 50 years so that I can get a return on my investment". Unfortunately, that means that millions of people will have to continue to suffer from preventable and treatable conditions.

That's capitalism for you.

 

[Michael Harrop]

They did a podcast on it:

https://slate.com/transcripts/LzZiRmhQQWliMTdVbFBrWXg1enU5TzZEbGVrM1ZrMUw1K0g1Y1VmTElLaz0=
What Next: TBD
Would You Buy Poop On the Internet?
June 02, 2024
Slate podcast transcripts are created using machine-learning software and have not been reviewed prior to publication.

It has some very incorrect statements about the screening/qualification process. They clearly have a specific narrative they're trying to push. They keep implying that places that accept 3% of applicants are superior to one that accepts fewer than 0.1%. While ignoring the fact that HMorg was started up due to widespread poor donor quality at every other source.

Speaker B: One of the doctor I spoke to who works at the Mayo clinic, I believe his quote was, horrible idea.
Speaker B: Terrible, terrible idea.
Speaker B: And for him, it just comes down to the fact that this stuff isn’t screened

This is just a flat-out lie, and they know very well that it's a lie. But it does give some insight as to why Sahil Khanna reportedly called it "a terrible idea". He was likely responding to "doing FMT from an untested donor".

Speaker B: Over the course of parting the story, I’ve become, like, an FMT believer.
Speaker B: Am fully convinced that we actually are on a.
Speaker B: On the cusp of, like, a medical revolution a lot of really smart people are excited about.
Speaker B: I find myself more convinced than I expected to be going into the story.

Interesting.

 

[Michael Harrop]

Someone having fun with it:

The J-Man Chronicles: Doodie-DoorDash. Freshly Frozen Feces, from Farm to Table. By Josh Bloom — June 3, 2024 https://www.acsh.org/news/2024/06/03/j-man-chronicles-doodie-doordash-freshly-frozen-feces-farm-table-17867

 

[Fmt2024]

Yeah unfortunately they think mocking a company that sells poop attracts more attention and clicks than them discussing how FMT genuinely benefits people. Again, they mock and unfairly criticize HM then talk about how they think FMT could be promising.

 

[Michael Harrop]

I think another possibility is that this piece was purchased by someone who doesn't want FMT to succeed. It could have been one of the companies that makes an FMT alternative drug or one of the many people who have invested in those companies.

I got the same sense from this similar Daily Mail article.

 

[Fmt2024]

Yeah definitely possible. Unfortunately, its much more profitable to have patients buy less effective FMT alternatives and less damaging to the economy of our current health system.