Strategies To Increase The Effectiveness Of FMT

anon2024

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I've been doing a lot of research on FMT and one of the questions I ask myself is why is it effective for some people and not others. I was watching a video with Will Bulsiewicz, MD and he was talking about the difference in efficacy for acute vs. chronic conditions:

https://www.youtube.com/watch?v=EABZqi3HtRM (1:46:33 - 1:53:35)

FMT seems to be effective for acute conditions (e.g. C. difficile) but not for chronic conditions. I know you've tried multiple FMTs and you're still struggling with health issues. The question is why are the microbes in the FMT not setting up shop in your gut.

I came across a video with Lucy Mailing, PhD about gut dysbiosis:

https://www.youtube.com/watch?v=s2LIHwicPQk

She makes a distinction between obligate anaerobes (OA) and facultative anaerobes (FA). OA can only grow in an environment that has little oxygen and are considered beneficial. FA can grow in an environment with or without oxygen and are considered pathogens. The colon of a healthy human is normally devoid of oxygen which promotes the growth of OA and inhibits the growth of FA. A simple formula for heath would be:

Eubiosis = OA > FA

One way to measure a healthy colon would be the production of metabolites (e.g. butyrate).

Conversely, the colon of a sick person would have oxygen present which would promote the growth of FA and inhibit the growth of OA. So, a formula for disease would be:

Dysbiosis = FA > OA

One explanation for why the FMT is not working is because you have oxygen in your colon which is preventing the beneficial microbes from growing. At 36:49, Lucy makes a number of suggestions to reduce oxygen in the colon. Have you tried supplementing with butyrate while doing an FMT? Have you tried a ketogenic diet? Fasting?

I recently spoke to Lucy and she recommended a product called ThaenaBiotic:

https://thaena.com/pages/faqs

It's basically a sterilized FMT so you get some of the benefits of FMT (e.g. postbiotics) with none of the risks. An interesting experiment would be to take ThaenaBiotic and an FMT together.
 
FMT seems to be effective for acute conditions (e.g. C. difficile) but not for chronic conditions
Disagree. C. diff is uniquely easier to cure because it's one known microbe, and the microbes needed to suppress it are more common.

There is plenty of evidence supporting FMT for many chronic conditions https://humanmicrobiome.info/intro/, but it requires higher donor quality.

The "procedure", "impact factors", and "outcomes" sections here https://humanmicrobiome.info/fmt/ go into more detail.

The info here https://maximiliankohler.blogspot.com/2019/12/fmt-roadmap-proposal.html about clearing the mucosa is relevant as well.

the colon of a sick person would have oxygen present
Citation needed. I don't see any citations in the video description, and the video only references a general blog (NGmedicine.com/blog).

Have you tried supplementing with butyrate while doing an FMT? Have you tried a ketogenic diet? Fasting?
Myself and others have tried these (and many other) interventions without much difference/benefit.
 
Citation needed. I don't see any citations in the video description, and the video only references a general blog (NGmedicine.com/blog).
Here's a blog post written by Lucy Mailing: https://www.lucymailing.com/the-oxygen-gut-dysbiosis-connection/

Here's an animal model study she referenced:

Kelly, C. J. et al. Crosstalk between Microbiota-Derived Short-Chain Fatty Acids and Intestinal Epithelial HIF Augments Tissue Barrier Function. Cell Host Microbe 17, 662–671 (2015).

and the link to the full study:

https://www.cell.com/cell-host-microbe/fulltext/S1931-3128(15)00122-5?_returnURL=https://linkinghub.elsevier.com/retrieve/pii/S1931312815001225?showall=true

Note, I did not see any human studies in her post.

Here's a video with Colleen Cutcliffe, PhD and Steven Gundry, MD on the colon, oxygen and microbes (no citations are provided):

https://www.youtube.com/watch?v=OKb_PcAJNaI (17 - 23)
 
Here are human studies on oxygen and the gut:

Oxygen battle in the gut: Hypoxia and hypoxia-inducible factors in metabolic and inflammatory responses in the intestine
https://www.jbc.org/article/S0021-9258(17)50153-2/fulltext

Human colon function ex vivo: Dependence on oxygen and sensitivity to antibiotic
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0217170

Physiologic hypoxia and oxygen homeostasis in the healthy intestine
https://journals.physiology.org/doi/full/10.1152/ajpcell.00191.2015

Dysbiosis in inflammatory bowel diseases: the oxygen hypothesis
https://www.nature.com/articles/ismej201380

Regulation of Oxygen Homeostasis at the Intestinal Epithelial Barrier Site
https://www.mdpi.com/1422-0067/22/17/9170
 
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