Thoughts on HumanMicrobes donor problem

arcty

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Hi forum. I'm a dilettante when it comes to the microbiome, but on HumanMicrobes and its struggles to find adequate donors, I have some feedback to offer.

For one, the result that most donor samples are unhealthy should not be a surprise. Mailing your stool sample to a random address in the slim hopes of a payout is not something healthy people generally do. The fundamental issue you're having is that healthy people, in all instances, stick to the norms and conventions of society and ignore everything outside of a pretty narrow window. And for something as fringe as FMT, even one of their friends introducing them to it would not be enough. This has been pointed out before, but your ideal donor probably lives a charmed life and they likely don't even need the money which supplying samples could provide them. Your typical demographic for offering up stool is much closer to the sort of person who sells his plasma than, say, those who donate their blood. Selling any part of your body is an act of desperation in most cases. You unintentionally attract the least healthy people in society.

Second, the hassle of mailing a sample is too great for anyone who isn't motivated by a monetary reward. Put another way, they're basically playing the poop lottery hoping they're lucky enough for their sample to pass. And just like the real lottery, the likelihood of getting chosen is miniscule. Conjure up a mental image of the average lottery player in your mind, or the average bingo player, and imagine that as your stool donor. That's a huge issue.

I believe M. Harrop is too hasty in his conclusions about the public health. It's bad -- but it's not 1 in 23,000 bad (given an even sample of the population). This method just attracts an unhealthy set of donors. The type of people you want don't even know you exist -- even if you send them an email or DM, they won't recognize your existence. The only way you could reliably attract college-aged atheletes, for instance, is through the university apparatus via things like paid samples for research which compensate generously to drum up interest. This would kill many birds with one stone: You target the exact group of people you want, screening/collection facilitated due to being in-person, everyone is paid so you get tons of donors, etc.

Now, that's a dream scenario. But if donor quality is of the utmost, sourcing directly from your preferred demographic is obvious. So I want to ask, has anyone done a deep-dive on the logistics of this? Has it been tried before? There's a clear demand for quality donors which is not being met by the current market; the university path might be our way to rectify that.
 
Thanks for your insight! I agree with much of it.

We did specifically look up and contact hundreds of college and professional athletes in the past, and the vast majority did not qualify or rank high. Including some of the top athletes in the world. It is true though that the vast majority of them just ignored us, and there are many top athletes that I'd love to be able to recruit, but have not been able to reach.

The only way you could reliably attract college-aged athletes, for instance, is through the university apparatus via things like paid samples for research which compensate generously to drum up interest
We tried that and did not get a response from the universities, unfortunately.

Mailing your stool sample to a random address in the slim hopes of a payout is not something healthy people generally do
That's not how it works. There's an outline on our Donors page.

I believe M. Harrop is too hasty in his conclusions about the public health. It's bad -- but it's not 1 in 23,000 bad (given an even sample of the population).
As far as "an ideal gut microbiome" it's actually looking to be far worse than 1 in 23,000. We're almost up to a million applicants and still haven't found a single one that meets some basic criteria.

Where I live, the vast majority of people I see are visibly diseased. And I live right next to a Blue Zone! I also see it in the news, etc. So I think the situation is quite dire. There are lots of "healthy-looking people" and I was expecting them to be good candidates. Thus my initial estimation was "1 in 1,000", which unfortunately turned out to be vastly overestimated.
 
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Interesting. Could you explain how people are being determined unhealthy if they meet all the other criteria like...
  • Age 18-25
  • In excellent physical/mental shape
  • Consistent type 3 stools
  • Minimal antibiotic use
I've read many of your posts, but haven't yet found a list of all the criteria that goes into screening. What is generally taking people out of the running after they meet the above criteria?
 
There is a 100-question questionnaire that is scored per question, then stool type and physical fitness. As noted in the blog, about 70-80% get disqualified from the questionnaire, with a majority of them being very unhealthy. Of those who submit the next steps, about 90% don't qualify or rank high due to stool type and/or physical fitness.
 
There is a 100-question questionnaire that is scored per question, then stool type and physical fitness. As noted in the blog, about 70-80% get disqualified from the questionnaire, with a majority of them being very unhealthy. Of those who submit the next steps, about 90% don't qualify or rank high due to stool type and/or physical fitness.
Stool types changed based on what you’re eating, does the harvesting ability of the microbiome have to do with the stool type or either you have the biome or you don’t? Could not one’s gut be potentially usable and Would tracking different diets and lifestyles be useful at all? If somebody was willing to be tested for many many months at a time without getting paid, to see how their body and gut changes with different requested diets and lifestyle
 
or either you have the biome or you don’t?
That seems to be the case.

In general, qualifying to be a stool donor seems very luck-based and if a person doesn't qualify there's not much they can do other than FMT from someone who does qualify.

Trying to upgrade a "7/10" quality donor by having them do FMT from a "10/10" donor is likely something we'll try in the future, but we have yet to find any 9's or 10's.

Could not one’s gut be potentially usable and Would tracking different diets and lifestyles be useful at all? If somebody was willing to be tested for many many months at a time without getting paid, to see how their body and gut changes with different requested diets and lifestyle
Diet is important for maintaining a healthy gut but is quite limited for recovery since it can't add microbes. https://humanmicrobiome.info/diet/

https://forum.humanmicrobiome.info/threads/while-antibiotic-resistance-gets-all-the-attention-the-damage-being-do.50/

Tracking diets and lifestyle changes is beyond the Human Microbes project. At least for the foreseeable future.
 
1 million+ applications is incredible. I find it so hard to believe that none of them have the ability to help more than your current donors who you found with <23k applications. Just to be clear, to qualify as a top donor you need a perfect or near perfect questionnaire, a decent physique, and type 3/4 stool?
 
Indeed. It is strange and frustrating. It makes me feel like it's a waste of time and it makes me feel like giving up all the time. Many of the 23k came from targeted outreach to hundreds of top college and professional athletes. The current #1 active donor is one of those athletes. In comparison, the million+ came from viral social media videos targetting the general public, especially people wanting to make some extra money. That is definitely not our target demographic.

Just to be clear, to qualify as a top donor you need a perfect or near perfect questionnaire, a decent physique, and type 3/4 stool?
Something along those lines.

EDIT: discussion here https://forum.humanmicrobiome.info/threads/chlorine-in-treated-drinking-water.320/ on chlorinated water, tribes, and other rural populations.
 
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Indeed. It is strange and frustrating. It makes me feel like it's a waste of time and it makes me feel like giving up all the time. Many of the 23k came from targeted outreach to hundreds of top college and professional athletes. The current #1 active donor is one of those athletes. In comparison, the million+ came from viral social media videos targetting the general public, especially people wanting to make some extra money. That is definitely not our target demographic.


Something along those lines.
OK then it seems possible someone who would fit my criteria would still make it to your list. It would be nice to see if that is true but I am unable to see many of their profiles. I noticed you mentioned recipients are allowed to choose from any one of your donors. Perhaps in the future, depending on what happens next with the FDA, you could decrease your prices of stool from donors who are not at the top? That would allow recipients to try donors who they think might be promising or most suitable for them. If they turn out to be super donors or at least very effective donors, you can always increase your prices.
 
For what it's worth, I found out about the donor search via a friend during what I'm guessing was the viral social media phase. However, unlike the motivations to apply that @arcty mentioned (which seemed well thought out and likely valid in many cases), my family would fall much closer to the "charmed life" group, and yes, it was definitely fringe enough that it wasn't easy to actually go through with sending in the samples (which I sent from my son, not myself). My rationale was that most of the people I'm close enough with to know about their stomach/bowel issues made me realize over the years that I seem to be naturally blessed in that regard (for lack of a better term!) So when I first heard about the campaign I was excited that I might be able to help someone else, but after reading the criteria, it seemed likely that my age and non-athlete status wasn't ideal. My 10 year old son, however, seemed to inherit my stable stomach/type 3 stool, and unlike me, he is very athletic and has never taken antibiotics! He was happy to provide samples because he likes helping people too, and the idea of getting "paid for poop" was an easy sell for a 10 year old boy. :) I don't know if his samples got lost in the flurry of the other 1 million at the time, or perhaps I missed a follow-up, which would be a shame because eventually his gut microbiome will likely get exposed to antibiotics at some point, along with the myriad of other factors that cause degradation in quality as age increases and life goes by.
 
A marketer shared some insight/advice with me:

People share things that make them look good to others.
I agree. I think there is quite an incentive for well-off people (such as world-class athletes) to become stool donors in order to say "I was the source of this cure for billions of people". Unfortunately, that hasn't really panned out. I think it might take a coordinated advertising effort, and we have no funding for that.

People like to pass along practical, useful information. News you can use.
I've been operating under that assumption for many years, and unfortunately, in my experience it doesn't seem to be the case.

Human Microbes is the perfect subject for a viral campaign. I was thinking of some short form video campaigns around “Save a life, share a stool story” for TikTok and Instagram where people talk about their wildest poop stories to remove the stigma around talking about stool, of course started by you. It’s similar to what ALS did with the ice bucket challenge but we take a more narrative approach.
That is very interesting. I like it. Unfortunately, we have no funding so all the social media videos are being organically created, and thus, I have no influence over them.
 
My thoughts: I've been a huge fan of the gut microbiome for at least 5 years now. I find myself reading every food label and researching every ingredient. The ingredients in food have a great impact on the microbiome. Especially, the preservatives that pickle our immune systems. Not to mention pesticides and plastics that are pervasive in our food and water supply. Even in organic foods.
Elite athletes probably don't have time to read ingredients and they may not be as healthy as you think. My application was rejected because I am 50 years old. But I bet my microbiome is healthier than many elite athletes.
Also, my family is very healthy and my kids rarely get sick. I've recently heard that people living together share bacteria. And looking at family history, we probably have cancer-protective genes as well.
So perhaps, the microbiome team hadn't been looking for the right donors. OR, perhaps it is nearly impossible to have a stellar microbiome, given the attacks on every front.
 
Hello!

I am here as probably one of the millions who were attracted by the offer of "easy" money.

I say this so you know I am still fairly new to this whole area of research and I after reading around this forum and some of the links I now have a huge respect for this endeavor. I applied back in Sept 2022 and remember receiving the email notifying me I was not selected.. not that surprising to me. I essentially forgot about it until I received the April Update email last week which has sparked a new interest in me.

I will be upfront and truthful about my motivations, the possibility of making $180,000 a year, however I understand now why a number like that has been advertised and how difficult it has been to locate ideal donors. And I understand that it is based from a need to find that donor to make advancements in this field that affects every person the planet.

So my question is (and I believe this was briefly addressed in another post) is it possible to "create" an ideal donor.. or as close to ideal as you can get.. through a contracted donor? And by that I mean, what if you could employ an "in-house" or "on-site" donor who is subject to a controlled & monitored diet and exercise regime? A person who will agree to dedication in order to produce the best possible donations for FMT?

I would personally like to explore the opportunity of this not only for the money, but also for my own/everyone's health and if possible to be a part of something truly world changing (saving?). Also, I noticed the legal address of this organization is in Riverside CA which happens to be my birthplace.. which I thought was a neat coincidence.
 
is it possible to "create" an ideal donor
Any intervention other than FMT is extremely limited since they will not add host-native microbes. So while there are a number of ways (diet, lifestyle) one can improve their health and gut microbiome, FMT is the only intervention that would be able to significantly "upgrade" a stool donor. This is why FMT is by far the most studied microbiome intervention.

I covered this in post #6 above.

Relatedly, I saw someone on Twitter suggest that Bryan Johnson would be a good stool donor. I don't think that's likely. That's not how the gut microbiome works. Inheritance and luck seem to be some of the biggest factors, along with antibiotic use and more. All the things Bryan does to stay young and healthy have quite a limited impact on both his health and his gut microbiome. More so, he would benefit from an ideal, young stool donor himself.
 
Any intervention other than FMT is extremely limited since they will not add host-native microbes. So while there are a number of ways (diet, lifestyle) one can improve their health and gut microbiome, FMT is the only intervention that would be able to significantly "upgrade" a stool donor. This is why FMT is by far the most studied microbiome intervention.

I covered this in post #6 above.

Relatedly, I saw someone on Twitter suggest that Bryan Johnson would be a good stool donor. I don't think that's likely. That's not how the gut microbiome works. Inheritance and luck seem to be some of the biggest factors, along with antibiotic use and more. All the things Bryan does to stay young and healthy have quite a limited impact on both his health and his gut microbiome. More so, he would benefit from an ideal, young stool donor himself.
I see, thank you for the clarification. And we are 100% sure that host-native microbes can not be "re-grown"?

What is your stance on extended fasting in relation to the microbiome? I've read that it has multiple "regeneration" benefits.

And I could see why someone like him might be suggested as a possible donor, but just from the fact that he takes 111 pills a day would disqualify him I imagine.
 
And we are 100% sure that host-native microbes can not be "re-grown"?
In large part, it's still unknown how these microbes get passed down generationally, and how exactly the infant microbiome develops https://humanmicrobiome.info/origins/, but with adults, FMT appears to be the only way.

What is your stance on extended fasting in relation to the microbiome? I've read that it has multiple "regeneration" benefits.
Better for its own thread, but from https://humanmicrobiome.info/diet/#impacts-limitations

Benefits of fasting, the ketogenic diet, and other dietary interventions, are dependent on the gut microbiome, and the benefits can be transferred via FMT [1][2][3][4][5][6].
I'll add more to that wiki page.
 
In large part, it's still unknown how these microbes get passed down generationally, and how exactly the infant microbiome develops https://humanmicrobiome.info/origins/, but with adults, FMT appears to be the only way.


Better for its own thread, but from https://humanmicrobiome.info/diet/#impacts-limitations


I'll add more to that wiki page.
Oh wow, I can see how this quickly becomes almost overwhelmingly complicated. Have you ever considered reaching out to the amish community? I know that seems kind of silly but I imagine they would have healthy mostly intact generational microbiomes. Although I have no idea if they would be available and willing to become donors..

Again, thanks for your replies and information, you're doing amazing work here!
 
A Superdonor In The US May Not Exist

I was listening to a podcast with Will Bulsiewicz, MD and he cited a study saying that over 200 million prescriptions to Abx were made in the US:

https://www.youtube.com/watch?v=SzqsMCu3KBY (11:16 - 12:05)

I was reading an article on babies born prematurely and the standard protocol in the US is to treat babies with Abx:

https://medicine.wustl.edu/news/antibiotics-in-preemies-has-lasting-potentially-harmful-effects/

According to https://www.marchofdimes.org/peristats/data?reg=99&top=8&stop=86&lev=1&slev=1&obj=9&dv=ms, 32% of live births in the US were Cesarean.

Based on this data, it's possible that a superdonor in the US does not exist. Have you tried focusing more effort outside the US (e.g. Australia, Europe, Asia)? Here are some people who understand what the microbiome is and may be willing to help you:

Simon Hill: https://theproof.com/meet-simon/
David Choe: https://www.youtube.com/watch?v=FRrbjiOs4no
 
A Superdonor In The US May Not Exist
I've already found 3 highly effective donors in the US.

You're right of course about those alarming trends that are making this much harder. https://forum.humanmicrobiome.info/threads/while-antibiotic-resistance-gets-all-the-attention-the-damage-being-do.50/

Have you tried focusing more effort outside the US (e.g. Australia, Europe, Asia)?
I have no way to do this, but HM accepts applicants from around the world. Antibiotic overuse, c-sections, formula feeding, etc. are now rampant around the world though, including those countries/continents.

Here are some people who understand what the microbiome is and may be willing to help you:
Feel free to reach out to them and let them know about the HM project. The first one has a podcast but my health is not good enough to do podcasts right now. The second one discusses the Hadza, which is covered here and elsewhere.
 
Amish

I know you discussed this in another post but I want to present some additional data. I was watching a video with Raja Dhir and Ara Katz, the co-founders of Seed, talking about the Amish:

https://www.youtube.com/watch?v=AJKZFI6ynlM (56:45 - 59:30)

According to Raja, the Amish have a healthy microbiome and do not experience chronic disease. He does not provide any references.

I found a study comparing Amish infants with urban infants and one of the findings was that the Amish infants had greater species richness compared with the urban infants:

https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2019.01509/full
 
Podcasters / MDs

Here's a list of podcasters focusing on health, fitness and the microbiome:

  • Rich Roll
  • Simon Hill
  • Ben Greenfield
  • Thomas DeLauer
  • Rhonda Patrick
  • Andrew Huberman

Here's a list of MDs actively researching the microbiome:

  • Will Bulsiewicz
  • Mark Hyman
  • Robyn Chutkan

I would be more than happy to contact these people on your behalf regarding donors.
 
Here's a list of potential donors
Lots of people in these categories have applied to HM. I don't have a specific way to target any groups though. I tried to contact top Crossfit athletes and they didn't respond.

Here's a list of podcasters focusing on health, fitness and the microbiome. I would be more than happy to contact these people on your behalf regarding donors
That would be great! Please do. But keep in mind that my health is currently too poor to go on any podcasts. However, some podcasters have discussed the HM project on their own.
 
I agree fully with arcty's post that started this thread. I am going to cross-post here a slightly modified version of my first post on this forum--which was originally posted on Michael Harrop's profile and was then moved to a thread discussing the rational for HMorg donor criteria. It's about my personal criteria--where athletics doesn't play much if any role.

I'm putting it here because this thread seems to invite more people brainstorming general criteria to recruit donors. And some people who are/know/want to recruit donors are in here (but not in that thread) so I'd like them to see this. In addition to maybe getting the attention of people who know potential donors, the point of this is that I totally agree that "fringe" is the exact OPPOSITE of what we should be going for (see my comment about the bell curve), and that factor works against us unless we actively try to mitigate it.

Here is a link to the post in question:
https://forum.humanmicrobiome.info/threads/the-evidence-and-rationale-supporting-our-stool-donor-criteria-2022-hu.131/#post-834
 
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