Comment by chasebank | Hacker News Reader

Comment by chasebank | Hacker News Reader

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I have a sample size of 1 as well. Probiotics didn’t help me but I’ve dealt with digestive issues for the last 4 years after a bout of food poisoning. I used to think gut flora / microbiome was quackery but I recently did an oral FMT (fecal microbiata transplant) the results were unreal.

For reference, I’m a 37 y/o fit male and donor was 18 y/o female. After 2nd week I got the deepest sleep since I was a child (slept for 11 hours straight - went to bed, teleported to the morning) and woke up with this hard to describe feeling. I literally felt like I was 16 again. This sort of optimism / happiness I hadn’t felt in years. And I’m a generally happy dude! All my symptoms went away and the euphoric feeling persisted. Whatever the bacteria did was truly remarkable. The bad news is a few weeks after the FMT was finished, things went back to the way they were before. I’d continue to do them forever but it was very expensive, $1400 for the month. Fwiw, I tried it again with another donor with zero results so I could have been a fluke.

I do think I’ll try it again with the original donor. It was a spectacular month. I really think the microbiome is a major key to our health and wellness. Remember the blood boy from Silicon Valley? I bet we see ‘fecal boys’ for rich people in the near future.

If you’re interested, I’ll link the source and study I based my dosage off below. The guy who runs the fmt operation very passionate about the concept.

[0] https://www.humanmicrobes.org/

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7866462/

I have no medical training. This is speculation only. Consult a doctor.

Assuming the translated gut flora to be the cause of your improvement then I'd look at two things. What bacteria the beneficial transplant contains, you can have it assayed (I believe it's called a bacterial culture test) and then find a cheaper source for that bacteria. Two, what the diet of the donor is, so you can try to replicate the beneficial environment in which those particular bacteria flourish.

AIUI, your own bacterial flora are in competition with the transplant. So, I wonder if a doctor would prescribe antibiotics (or something else) to wipe out your own flora, then the new flora (possibly with a diet change) would have a greater chance of taking hold?

I wonder also if the causal flow is different here, that there's maybe an underlying condition that is causing the gut flora to not prosper (like making an excessively acid environment).

According to books such as "¡Es la microbiota, idiota!" (ISBN 8413440688 but I don't know if it's available in english) it's not that simple, I think they said that not all the strains are identified and even then there are strains that aren't easy to grow in vitro (I'm NOT a scientist, don't quote me on this, I just listened to the audiobook).

What they make a point on is diet, she insists on the importance of having a diet that gives desirable bacteria strains an environment where they can thrive to achieve a balance.

IIRC she also mentions how it's not as simple as having "good" and "bad" strains and how balance is key.

It's a really interesting and funny book to listen to if you have a few hours for it.

So in the case of OP I think you're right about finding out more about the donors diet and replicating it as well as adjusting anything necessary for the newly arrived colonies to last through time.

I don't know sh!t about it nor do I intend to sound like I do so please correct me if I'm wrong.

> "¡Es la microbiota, idiota!"

Ha! As someone who has done clinical research on human subject on gut microbiome following blood & marrow transplants, this title is truly, truly great. My old lab needs t-shirts with that on it!

Do you think you would have slept like a baby if you knew the donor was a longshoreman that looked like Larry the Cable Guy as opposed to an 18 y/o woman? The way you describe the details with such fervor I'm surprised you didn't ask the doctor to skip the trouble encapsulating the sample in pill form and offered to dispense it yourself. In all seriousness I wonder if there isn't a subtle psychological effect that isn't being taken into account here.

This is what doctors call "the honeymoon phase", and it can happen with various drugs and supplements.

If it stops working, and you can't reproduce it the second or third time, then it's probably better to give up and look for another solution.

This would have been the strangest placebo I've read so far.

Placebo effect can be very powerful to IBS[1] and other digestive issues, as well as anything psychological. It seems very plausible that this was just the "honeymoon" effect.

1. https://pubmed.ncbi.nlm.nih.gov/15916620/

I get the influence of 'mind' over perception of reality but OP seemed to have a better time than the best coke newbie ever. His word are describing some golden dream of all people after 30, not just "it made me healthier".

I wonder if it would be worth finding out about the donor's diet, and trying to replicate it after the transplant in an effort to maintain the gut flora.

Are you sure you don't have sleep apnea? I did... or rather I do, but if I sleep with a CPAP machine, I wake up with a feeling like you describe.

I hate that machine, but it works.

I'm pretty sure I don't. I suppose I could try one out or get a test.

You said you're fit, but it's still possible to have sleep apnea.

Incidentally I had it and never knew about it until I had the sleep study. I never woke up gasping for breath or anything like that.

I've been fascinated by FMT, but it also grosses me out. I'm super curious, was it tough mentally to take the pill if it was a pill?

Not at all. They are just 00 size capsules and easy to swallow. Didn't bother me one bit. Personally, the idea of consuming someone else's poop is less bothersome than taking most pharma pills. Terrible logic, but that's just how I feel.

I got in touch but he is reluctant to recommend a dosage, order size etc. presumably for legal reasons.

How much did you order, were they prepackaged capsules, did you go on an antibiotic regimen ahead of time? I'm not sure if I want to take a chance at 1400 for a month that things rebound to the way they are now but I'm desperate.

This was a fascinating read, thank you for sharing. Were there really no lasting effects? I'm curious why the introduced bacteria didn't flourish and permanently change your microbiome. Can anybody weigh in?

It might be that they have to hit a certain critical mass to become self-sustaining. Or they require a particular environment to thrive, which exists in the donor but not in the donee. It's such a new field, at least for prescriptive medicine, that it'll probably be a while before we get a good base of understand of what lives in our gut, what it does, and how to keep it healthy.

My money is indeed on the environment. You'd want to know what that donor was eating, and try to replicate it.

We are what we eat. Could try changing to the same diet as the donor...

Thank you for that. I've wondered if those transplants stick.

Hopefully this becomes an area of major research because all the anecdotes sound so promising.

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