FMT (poo pills) released commercially

[kangaSue]

I guess if one day these FMT pill drop in price, then people might be able to afford to take them every 3 months say. In fact, if these pills improved you enough so that you could get back to work, you could probably afford to take them every 3 months even at current prices (of $635 a time).



I wonder why KDM's experience with fecal transplant indicates the improvements in ME/CFS only last 10 weeks, whereas the Borody study I cited above found that for ME/CFS patients with comorbid IBS, the fecal transplant benefits lasted indefinitely (sustained for two decades so far).

I don't know anything of KDM's work on FMT. Both the study you posted and the comment I found dated from 2012, would be interesting to know if KDM still maintains that line.

From a quick search it looks like KDM still maintains that line. I get the impression he isn't a big proponent of FMT. Call me cynical but there's always the possibility that there's more profitable products to peddle.

 

[cigana]

I guess if one day these FMT pill drop in price, then people might be able to afford to take them every 3 months say. In fact, if these pills improved you enough so that you could get back to work, you could probably afford to take them every 3 months even at current prices (of $635 a time).



I wonder why KDM's experience with fecal transplant indicates the improvements in ME/CFS only last 10 weeks, whereas the Borody study I cited above found that for ME/CFS patients with comorbid IBS, the fecal transplant benefits lasted indefinitely (sustained for two decades so far).

Interesting point, I wonder if Borody's methods are superior. Shame that he seemed to use Fukuda criteria, but the study seems very promising, I hope there is more to come.

 

[kangaSue]

personal experience shows that fecal transplants (via enemas, 10 days in a row) did not help my ME, but worked for constipation. and an ME friend went from only tolerating 3 foods, literally, to eating all types of food, just from fecal transplants (enemas). so that means these poop pills would likely work for constipation and some types of food intolerances too.

NOTE TO DOCTORS: why not see if you can order from the company (OpenBiome) these for your patients who need them, even if they don't have c diff...?

@Rrrr, I don't suppose you and your ME friend did fecal transplants using the same donor. That would be an interesting comparison.

 

[Thomas]

I did a FMT back in 2012 under the supervision of the late Dr. Bradstreet when my ME was quite mild. It didn't do anything for my ME or my IBS really. I would still consider these pills though as they are a much more pleasant delivery system, but I feel like the benefits of FMT's in the ME population have been mild at best. Most I've spoken to have had no response or bad response.

 

[acer2000]

I wonder if the difference is in the method or the strains of bacteria?

 

[kangaSue]

I wonder if the difference is in the method or the strains of bacteria?

I think Openbiome's capsules would be superior to any other available product or treatment from other clinics as they use an anaerobic extraction and processing method to make the capsules which are then snap frozen and stored at -80 deg. The capsules have to remain frozen until use to preserve these anaerobic species.

By the way, it's stated on Openbiome's website that they charge an additional US$150 shipping and handling fee per order.

 

[acer2000]

So who wants to try it?

 

[taniaaust1]

if using individual donors, there would probably be huge differences in their bowel floras so therefore in what a person may receive.

I wonder whether these capsules are like more standardised.

 

[kangaSue]

if using individual donors, there would probably be huge differences in their bowel floras so therefore in what a person may receive.

I wonder whether these capsules are like more standardised.

I can't see it anywhere on their website in regard to their commercially available products but I recall reading in earlier research papers that samples from up to six screened donors were mixed in a batch to get the widest spectrum of species. If that is the case still, every batch will have some variation.

From memory, lack of standardisation is one of the problems that the US FDA has with allowing FMT as a medical treatment. At least openbiome has a standardised screening procedure, only 3% of potential donors make the grade in this part of the process according to their website.

 

[M Paine]

Let's just say, for arguments sake, that a microbe population is thriving when it shouldn't. Sort of like weeds overtaking your garden.

If planting lots of great plants every 6months works, but the weeds and vines still grow back and kill off the desirable plants... Do you keep planting?

If the immune system is at fault, and the proverbial gardener (immune system) is not pulling out the weeds before they flourish, what can we do?

We know that the garden also has strange animals living in it, which also selectively destroy weeds (phage in mucosal membranes), could they be missing from the garden? Could the gardener be also killing them on sight, instead of letting them help with the weed issue?

When we reseed the garden via fecal transplant or otherwise, lets not forget that we also repopulate the garden with its animals too (phage)

Can we retrain the gardener, make him forget which plants (bacteria) or animals (phage) he thinks are bad? (destroy all B-lyphocytes e.g. Rituximab)

We know that spraying weed killer (antibiotics) kills off the desired plants as well as the bad, giving temporary relief, but leaving us with a mostly empty garden, to eventually return to an overrun weed fest.

Could targeted antibiotics be an answer? Antimicrobial peptides, or phage therapy could selectively knock out specific strains (weeds).

Obviously this is all a stab in the dark. The mechanism of rituximab is not known as far as the relationship between culling b cells and curing cfs. Or if the microbiome is relevant to cfs. But it's still worth pondering.

If I could easily access these pills, I'd gladly try them out.

 

[kangaSue]

@M Paine It's all in the soil, good plants won't out compete weeds in poor quality soil so the gardener needs to change suppliers for a better balanced fertilizer mix. Then your healthy plants give off exudates to deter the bugs.

You could similarly be describing SIBO and why that doesn't resolve in some people. In theory it is held at bay by the self leveling of bacterial species and only becomes a problem when the system goes out of whack for whatever reason and can't return to the status quo until the right balance of bacteria "sticks" in the system again. For both SIBO and FMT treatments to work, I expect it is likely closely tied to issues of a permeable gut and/or malabsorption of some nutrients vital for feeding some bacterial species to give them a fighting chance of re-establishing themselves.

openbiome sells the superior product, failing that, for the best blend of bacteria in FMT you want the donor to be vaginally born with no exposure to antibiotic use and preferably male as they have far fewer hormonal influences to deal with but that's a hard order to fill, either going through a specialist centre or from a d.i.y. donor.

Do you happen to have a good relationship with a G.I. specialist. To keep the FDA sweet, openbiome will only sell to doctors, purportedly to treat C. diff but there is no enforcement of use in place that I have heard of and it's up to the discretion of the G.I. who carries the risk of who they use it on and for what condition they choose to try it for.

On rituximab, I read that with some forms of autonomic neuropathy (Autoimmune Autonomic Ganglionopathy is what I was researching), it works by reducing the level of antibody titres (to alpha 3 nicotonic acetylcholine receptors in the case of AAG, these antibodies also being known to be associated with POTS and Orthostatic Hypotension). Rituximab's effect was an incidental finding as a side effect in patients being treated for cancer with a co-morbidity of AAG but similarly works in cases of AAG due to restricted form of autonomic neuropathy).

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3725638/
http://www.ncbi.nlm.nih.gov/pubmed/20634694

 

[trickthefox]

Only in a capitalist society would they find you a way to sell you back your own shit in tablet form haha *sigh*

 

[trickthefox]

On a serious note, this sounds promising. Its been in my mind for ages that probiotics have their obvious flaws given the gut is comprised of millions of bacteria that taking a probiotic with 5 or 6 strains is like trying to rebuild an entire jungle ecosystem with a single plant! Viva la poopills

 

[Justin30]

So you take your poo pill and you have a compromised gut mucosa, dybiosis and bacterial translocation and you eat a poop pill and give yourself a healthy dose of sepsis....

They did find that in the other immundeficieny, HIV that both the epethilial lining of the gut and the bbb is compromised. They may work for some but....until further research you could be giving yourself a nice fat dose of LPS/Endotoxins and Neurotoxins to your already messed up body...

I wouldnt eat one if I had definitive proof my immune system isnt working and like all healthy immune systems 70 or 80% of those immune cells sit right behind the epithelial layer of the GI track.

Just my thoughts.