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Comment by programmarchy | Hacker News Reader

> Davar and colleagues collected fecal samples from patients who responded extraordinarily well to anti-PD-1 immunotherapy and tested for infectious pathogens before giving the samples, through colonoscopy, to advanced melanoma patients who had never previously responded to immunotherapy. The patients were then given the anti-PD-1 drug pembrolizumab. And it worked.

It's pretty crazy that your gut biome can change the way your body responds to skin cancer treatment.

Could this work for basically anything immune-related? Maybe people who got COVID but were asymptomatic could donate some poop.

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This is something that I've been thinking for quite some time now (i.e. pre-COVID and just generally health related).

I was on lots of anti-biotics as a kid and I turned from skinny to fat at some point. We know already from experiments/treatments being made that fecal transplants can make a fat person skinny for example (no I didn't do that :))

Personally I transformed my life from being very lethargic and not being able to tolerate anything but small amounts of certain foods and also alcoholic beverages without getting major migraines by getting the right probiotics. To give you an idea, eating leftover lasagna two days in a row was a sure fire way to get a migraine, as was drinking a bottle of alcohol-free beer and anything with alcohol was even worse. Even just small amounts. We're talking migraines where you feel like you're gonna puke and my eyesight was affected as well.

I felt really sick for about 2 weeks after starting the right probiotics. And it wasn't just any probiotics that would do. I tried out different ones, until I found a specific one that mainly differs in one bacterium from all the others I tried. Bacillus subtilis in case you're wondering. During that time my then current microbiome would've been fighting with the newly introduced strains. After that, I was no longer lethargic and slowly but surely I was able to tolerate foods in normal quantities again. Leftover lasagna is just awesome now, like it should be!

So yeah that's just a personal anecdote on how gut health can really eff up your life and health. So I can very well believe that people with a 'broken gut' would die more easily from COVID or get infected more easily with other things as well. But where's the money in simply fixing peoples guts? Isn't it 'better' if we make them sick, so we can then prescribe them stuff?

What supplement/brand/company do you use?

The one I found is available to me here is Garden of Life - Primal Defense Ultra: https://www.gardenoflife.com/primal-defense-ultra-probiotic-...

It has Saccharomyces Boulardii, like many if not most Probiotics, which is already good and I tried that one in isolation before as well. Then it has various Lactobacillus strains that are common in most Probiotics in some combination or another. If you specifically have problems with histimine, like me, then the different strains actually matter, because some produce histamine, while some reduce it or have no effect on it. I had tried various other probiotics that basically had zero effect, while this one had an effect. I can't prove it, but the only real difference on the labels I found was that this one had Bacillus subtilis, while none of the others I tried had it.

There are actually some Lactobacillus, that made my condition _worse_. You may know Danone Actimel, which makes probiotic claims. I can attest that they are true. The do have active Lactobacillus casei. I know, because it caused me headaches, because Lactobacillus casei actually _produces_ histamines, which is the cause of my migraines.

Worst headache I've ever had in my life was with a Zinc pill. Back then I had no idea why I sometimes got headaches. The capsules were Zinc + Histidine. Histidine being converted by the body into Histamine ... Which btw. is (big part of) what makes your hangover headache.

The other good thing is that if I now have a "slipup", I just take a Benadryl and it's all gone :)

Just one more question: do you need to continuously take them to have good effect or after some time (months or bottle) you are fine also without them?

I haven't really tried not taking them at all for prolonged periods of time. But I did start off with just one a day, went to two a day, then three a day. That was to slowly ease into it, while the existing bacteria in my gut would 'fight it out' with the new guys and slowly introducing more and more of the ones I wanted to be in there to crowd out whatever was in there before.

Now I'm on one in the morning and one in the evening but I don't sweat it at all if I forget. I might be totally fine with just one.

Some of the strains definitely just stay for a little while. Saccharomyces Boulardii for example IIRC usually isn't capable of hanging around forever if it's not replenished from the outside. You can get a lot of these from eating things like Sauerkraut. AFAIK Bacillus Subtilis is a bacterium that people in previous times would have naturally gotten from eating stuff from their garden, i.e. it's a "soil bacterium", so if you ate cabbage from the garden and you couldn't get _all_ the dirt and included bacteria off it, you might have gotten some Bacillus Subtilis with it.

I do have a garden but don't eat enough stuff straight from it I suppose :)

Thank you for mentioning Bacillus subtilis. Will look into it more.

The question I have is how to evaluate the 'proper?' gut biome / fecal "recipe" to get the desired outcome?/Expression?

So what characteristics would a good vs bad donor gut biome/fecal biome be?

> The question I have is how to evaluate the 'proper?' gut biome / fecal "recipe" to get the desired outcome?/Expression?

You and the rest of the medical community. This is largely still an open question.

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