DNA stool analysis before and after FMT? Outcomes

[Raptor]

I've been DNA stool testing my microbiome for close to three years every 3 months. I had been through 10 rounds of antibiotics over a few years and was left with severe cramping, hypersensitivity, histamine reactions, as well as other issues. I was left with diversity in the 5th percentile. I became very familiar with the DNA results and reading the reports.

Is there any evidence of what your biome looked like before and after an FMT? I could see what 1 round of antibiotics did my comprised biome from the DNA testing during real time. I had multiple DNA tests done before and after a round of metronidazole and could clearly see how it impacted my biome initially and over time. I would like to see similar evidence before and after FMT.

 

[SFBayFMT5]

How about you re-test after doing a FMT, since you're familiar with your pre-FMT results?

As far as existing data, if you read almost any scientific paper about FMT they will show pre- and post-FMT microbiome data from the recipients, organized by phylum, genus, and sometimes species. They quite often will also show the microbiome profile of the donor(s).

In general, the recipients' microbiomes change in the direction of their donor, though not "all the way" (in other words, they don't acquire ALL species from the donor, and often not to the level of abundance of the donor, rather partway between the donor and their starting abundance). This the overall big picture, sometimes bacteria increase in the recipient that weren't found in the donor. And among the ones that DO shift toward the donor, it's often highly skewed in terms of which change how much, in other words the recipient doesn't move proportionally along a line connecting his/her starting profile to the donor's, but instead might move 90% of the way toward the donor along some dimensions and only 15% of the way along others. Also how durable the change is varies widely.

 

[Michael Harrop]

That's a big waste of money. You're better off spending your money elsewhere. https://humanmicrobiome.info/testing/

 

[Raptor]

Basically I was curious if the 16s RNA test would show large change initially after FMT or would the new bacteria need to settle and propagate. For example, I have little to no Akkermansia and zero Oxalobacter in over 12 DNA tests over 3 years. The new bacteria would have to live and replicate. I am wondering how that data would look. Not just raw numbers but also percentage of biome.

Also, I'm in the 5th percentile in overall diversity. What would it look like a month after FMT, a year after?

 

[SFBayFMT5]

That's a big waste of money. You're better off spending your money elsewhere. https://humanmicrobiome.info/testing/

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That's probably true in terms of actionable information for the test taker personally. It's not like a test anyone takes right now will tell him or her whether FMT is promising or if so which donor to use. So basically if you take a test now, you're investing in the future of microbiome research--you can tell people what worked for you and what your microbiome looked like and others can try and draw conclusions from pooling your outcome with others.

Even in terms of truly understanding the gut, the current tests might not provide the answers. I suspect that what's most important isn't what species are living in the rectum, but what genes are being expressed in all the different compartments from mouth to colon. Even if this were the case, test results could contribute to knowledge, but likely in a correlative fashion, i.e. which species are in the stool may be a marker for what you really care about even if it isn't itself what you care about.

Basically I was curious if the 16s RNA test would show large change initially after FMT or would the new bacteria need to settle and propagate. For example, I have little to no Akkermansia and zero Oxalobacter in over 12 DNA tests over 3 years. The new bacteria would have to live and replicate. I am wondering how that data would look. Not just raw numbers but also percentage of biome.

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If you did FMT via the lower route you'd of course detect the donor's bacteria immediately after. Even if done by the upper route you would likely see something, the question is what it means. In terms of Oxalobacter specifically, if your donor didn't have any either then there's no reason to expect it to appear post-FMT. Akkermansia is something that most healthy people have in decent amounts so that's a different story.

Also, I'm in the 5th percentile in overall diversity. What would it look like a month after FMT, a year after?

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It depends on if your donor's bacteria "take". If they don't, then a week after FMT you could have your old balance back. Obviously if you do some kind of antibiotic pre-treatment then diversity should increase post-FMT since the niche is undersaturated, if you just go from a stable pre-FMT balance to adding some bacteria via FMT then it doesn't need to. Again I would look at published papers that trialed FMT for different indications to see what they saw.