Should I try to increase or decrease my gut microbiome diversity before doing a FMT?

pfsguthealer

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In early January 2024, I will probably attempt a Fecal Microbiota Transplant, with a healthy young donor, in an attempt to cure a Post Finasteride Syndrome, which manifest by depression and low libido.

We have good scientific evidence that Post Finasteride Syndrome is in good part caused by gut dysbiosis, which in turn cause a lack of production of neurosteroïds and neurotransmitters, as per https://pubmed.ncbi.nlm.nih.gov/32951160/ ; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9687671/ ; https://www.sciencedirect.com/science/article/abs/pii/S0306453018305067

FMT for PFS has already produced several complete remissions, it is a serious therapeutic option.

Now, before I do the Fecal Microbiota Transplant from my healthy donor, I have two options :

− try to enrich my gut microbiome diversity, by eating a lot of fiber, kefir, sauerkraut and probiotics

− try to deplete my gut microbiome, with raw carrot, oregano oil, coconut oil and vinegar, in order to facilitate the takeover of my donor microbiome.

Which of these two options seems reasonable to maximize the success of the FMT ?

This article suggest that low diversity in the recipient will favor the takeover of the donor microbiome strains https://doi.org/10.1038/s41591-022-01913-0

But this article suggests that recipient microbiome diversity favor FMT success for Ulcerative colitis and Irritable bowel syndrome, but not Metabolic syndrome
https://doi.org/10.1038/s41575-021-00441-5

I’m puzzled
 
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