Today on the Gut Health Reset Podcast, we are discussing the emerging field of Fecal Microbiota Transplants with Dr. Shaina Cahill! The gut microbiome is a hot topic in the world of health and wellness, and for good reason: gut health has been linked to everything from weight loss to improved mood and cognitive function. So it’s no surprise that researchers are looking for ways to optimize gut health. One promising area of research is fecal microbiota transplants (FMTs).

FMTs involve transferring healthy gut bacteria from one individual to another. Stool from a healthy donor is transplanted into the gut of someone with an unhealthy gut microbiome. The donor stool contains a diversity of healthy gut bacteria that can help to restore balance in the recipient’s gut. FMTs have been shown to be effective in treating conditions like Crohn’s disease, ulcerative colitis, and irritable bowel syndrome.

While more research is needed to fully understand the potential of FMTs, there is promise that this therapy could one day be used to treat a variety of gut-related conditions.

 

We will answer these questions:

– What is a Fecal Microbiota Transplant (FMT) and why would you want one?

– How can FMT transform your gut health?

– How are FMT donors vetted and screened?

– Where can someone go for more information on FMTs?

– And more!

 

Still want to learn more? Schedule with Dr. Barter today!

 

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About Dr. Shaina:

Shaina is a neuroscientist with an interest in alternative medicines that utilize the body’s innate systems and a passion for medical education and scientific communication. She received her doctoral degree in Neuroscience from the University of British Columbia and has been working in the field of medical affairs in non-traditional medicines for the last three years since leaving academia. She is currently the Director of Medical Communications and Affairs at Novel Biome, which provides high-quality medically supervised Faecal Microbiota Transplants (FMT) for children with autism spectrum disorder (ASD). Part of her role is to help spread educational and scientific information about the microbiome and FMT that is accessible, accurate and digestible.

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Dr. Ann-Marie Barter is a Functional Medicine and Chiropractic Doctor at Alternative Family Medicine & Chiropractic. She is the clinic founder of Alternative Family Medicine & Chiropractic that has two offices: one in Longmont and one in Denver. They treat an array of health conditions overlooked or under-treated by conventional medicine, called the “grey zone”. https://altfammed.com/

https://drannmariebarter.com/

*As always, this podcast is not designed to diagnose, treat, prevent or cure any condition and is for information purposes only. Please consult with your healthcare professional before making any changes to your current lifestyle.*

 

Transcription:

Today on the Gut Health Reset Podcast, we don’t need too much of an intro. We are talking about fecal microbiota transplants or F M T. Stay tuned for all the details, but thank you so much for joining us here today on the Gut Health Reset Podcast. I’m your host. Dr. Annemarie barter, and today my special guest is Dr. Shaina Cahill, who is a neuroscientist with an interest in alternative medicines that utilize the body’s innate systems and a passion for medical education and scientific communication. She received her doctoral degree in neuroscience from the University of British Columbia and has been working in the field of medical affairs and non-traditional medicines for the last three years since leaving academia, she’s currently the Director of Medical Communications and Affairs at Novel Bio, which provides a high quality medically supervised fecal microbiota transplants.

F M T for children with autism spectrum disorders, a s D. Part of her role is to help spread educational and scientific information about the microbiome and F M T that’s accessible, accurate, and digestible. Well, Shayna, thank you so much for being here with us today. I’m really actually looking forward to this topic because there is just a lot of questions around this one,

Yeah, it’s definitely a more interesting. Topic as like, it’s kind of mixes things people are uncomfortable with, with really exciting science. So it’s always a good, it’s always a good conversation starter. So

we’re gonna dig, I think, right into the meat of it, if that’s okay. So why in the world would we want to do a fecal transplant?

Yeah. So the idea here is that your gut microbiome kind of plays a huge role in a number of function. Ranging from like modulating your immune system to like processing the food you eat, to communicating with your brain. So it’s like really far reaching. But what can happen is the makeup of your gut microbiome can be damaged in a number of ways.

And at some point you reach a threshold where doing natural changes, changing your diet, sleeping better, exercising can no longer bring back that dysfunction. And so you get to a certain point where the gut isn’t something called gut dibis and just means the gut isn’t able to function at the, at the rate that it.

And when you get to that point, you really need bacteria being put back into the gut to teach your gut what it should be doing. And so this is where fecal microbiota, transplantations or F M T come into play, where you take a healthy donor’s gut microbiome from their stool, which has like active bacteria in it.

And so these donors are, are really highly screened. We’re looking at everything from blood and stool screening, but as well as we look at their family history and their current and past medical history, they had an understanding of. Everything that could impact the gut microbiome. This comes from like every couple of days to every couple of weeks something new and exciting is coming out about what the gut can do.

So what we do when we’re screening is to ensure that anything that could possibly affect the gut is not in our donors. You purify their samples down. So it’s just the bacteria, the good stuff the gut microbiota that you want, and then someone who has gut DI is gonna come and get that trans. And we do at our company at Novel Biome, we do oral capsules, oral powders, and retentions.

One of the more popular or the gold standard is a colonoscopy as well. Colonoscopy is now kind of is what we compare every other method to, and we’re finding oral capsules at the same outcomes which is just, it’s a little bit easier than having to have a colon. We put this new bacteria in.

Basically, the idea here is it reeducate the gut. Normally during gut dibis you have a really low diversity, so it’s, it’s not as many or the different types of bacteria you want there. So before you get fmt, normally you’re given like an antibiotic to kind of wipe out what is there. We put this new bacteria in that we know is a healthy and well-functioning gut microbiome, and then it teaches the gut what it should be doing and how to do, how to be its best self, is kind of the idea behind it.

Mm-hmm.

and. Disease states, are you really seeing incredible changes

with Yeah. So right now FMT is only approved for the use with C Diff. Mm-hmm. c Diff film sections. And so outside of that, we’re kind of seeing a lot of new research coming out. So personally at our company, we focus on autism spectrum disorder.

There’s been some groundbreaking work that’s really shown that. Kids with a s d have a lot of GI syndromes are actually three times more likely to have GI issues. And those GI issues tend to be more severe. So the use of F M T originally was kind of targeted at trying to alleviate these GI symptoms and kind of try to help the gastrointestinal SY system function better.

But what we see is a secondary effect we see at the company. And this previous research we’re seeing that changes in autism related behavior. And so it seems like it’s a system so when we change the gut, we’re changing these, these kind of behaviors. There’s also work being done. In inflammatory bowel disease, irritable bowel syndrome, but as well as diseases like Parkinson’s and multiple sclerosis as well as Alzheimer’s disease.

There’s a lot of new clinical trials coming out, trying to understand. We know that there’s gut dysfunction in these diseases and some early preclinical or animal models as well as some kind of case studies in humans. We’re seeing changes in the gut lead to changes in these kind of Outward behaviors or, or neuropsychiatric symptoms.

So it’s a really exciting field. We’re learning kind of more every day, but the, the variety of diseases kind of grows as we learn more about it. And some of these is we’re, you know, the first system is always gi and we’re seeing secondary outcomes, but we have disorders like in cancers. Some of the treatments that you do are, are quite hard on the system.

And so there’s been some studies coming out that’s showing people that are getting stem cell treatments. What has to be done to prep the body to be able to get a stem cell treatment is quite invasive. And so they’re finding, if they put do an F M T treatment during this process, it actually helps with reducing rejection of the stem cells as well as kind of increasing overall kind of comfort and health in these patients.

So it’s kind of wider reaching and it, it literally changes every couple of days, which is exciting. Keeps me very busy. .

Well, just outta curiosity, cuz you guys really specialize a lot in autism, I think that that’s your, that that’s your main specialty, correct? Yes. So what are you guys seeing in, is there anything that is similar in the guts of children or of adults that have autism?

What are

you seeing with. Yeah, so I think the first thing to understand is that the gut is really por important in development. It seems to be tied to cognitive function. We know the brain goes through these critical periods, so these certain things have to happen for brain development to kind of progress.

We’re actually seeing these same kind of trajectories in the gut. And when we’re looking at children with a s d, their gut from the research seems to be. Underdeveloped, so it doesn’t match where neurotypical pairs are in kind of that developmental trajectory, as well as their guts in general don’t look the same.

The makeup is different. And then we’re also seeing these GI symptoms. On top of that the severity of GI symptoms seems to be related to the severity of autism related behaviors as well as neurotransmitter cascades are different. So serum level, serum levels of neurotransmitters are different, but as well as the process in which the gut makes neurotransmitters, those, those kind of pathways are also destructive.

Overall, it seems like the gut is, is really tied to the development of, of a s d. And so it’s not to say that like gut dysfunction causes that, but it seems to be part of the process. There’s two major studies and these are the studies that kind of spurred kind of the development of our company based on kind of parents outreaching.

Wondering could, could F m t, you know, be a solution to kind of helping with GI symptoms, but as well as some of the other, the other issues related to, to having a child with a s d. So the first study came out, Dr. James Adams group in 2017 from Arizona State University did Did a study where they took children with a s d they did a gut prep, which included an antibiotic, which is prepping the gut so they can better take gut in new bacteria.

And then they did two days of high dose fmt and then eight weeks of a loading dose, which is just a small dose of a long period of time to ensure that basically the best in ingra mentor or uptake of this new microbiome. And after that eight weeks of treatment, they looked eight weeks after that and they found that GI symptoms were 77% improved.

But they also saw 23% improvement in autism related behaviors and a shift in the gut microbiome to be more towards typically developing pairs. They then in 2019 did a two year follow up study, and this is kind of the one that still blows my mind. They looked two years after, so they did eight weeks of F M T and they looked two years after that and they found that GI symptoms were still improved, but.

Autism related behaviors continue to improve over time. So parents noted this as well as when looking at all of their measures, they found that instead of being 23% improved, they saw originally it was actually 47% improve from baseline. So these, these behaviors continue to improve with this new gut microbiome.

They saw, also saw a shift in where these children would fall. So a s d is kind of sorted into being, you know, you have severe cases or they’re, they’re sorted as severe, and then you have mild and moderate and, and under the, kind of, under the cutoff. And so originally most of these children would’ve been sorted as severe and after two years, most of them actually.

From being, not even being categorized on, on these standardized measures of, of, of having a s d. So these, these are huge changes and that’s kind of what spurred us to kind of really focus in on, on children with autism and providing F M T because it’s, it’s. It’s kind of magic what’s happening. And just changing the GI symptoms improves quality of life, but all these secondary outcomes we’re seeing in autism related behaviors are really important and they, they really do make a huge difference.

So

how long has your longest follow-up study been? Is it the two year follow-up

study? Yeah, the two year’s the longest right now. That one came out in 2019. There are some new studies coming out that have longer time windows, but they weren’t there’s no initial study. So what they’re looking at is like, well, what does it look like now?

They’re not kind of comparing back to their original baseline. At our company, we are doing our own internal kind of keeping track of all these documents. And so that’s something that our goal is to kind of have these, these follow ups long term so that we can help kind of add to this data pool. But it’s, we’ve, most people haven’t been doing it for long enough to have longer follow ups than kind of this, this two year follow up at this point.

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Chow. And now back to our episode,

you, you also said that in autistic children or a s d on the spectrum in some, in some re some way that their neurotransmitter pathways were destroyed in the gut.

Do you know specifically which ones were destroyed or altered or were there

Yeah, so they’re They’re, they’re biosynthesis pathways. So this is basically like how the molecules are transformed into becoming a neurotransmitter. It seems like there’s some dysfunction there. There’s no definitive, like these ones are the ones that are changed and these ones aren’t.

There has been studies that have shown dopamine seems to be altered, neuro epinephrine. We’re just now, I think, fully understanding how much the gut produces neurotransmitters. And so I think we’re starting to really start to kind of dig into that more. Some of the, our understanding that the gut could even make neurotransmitters has only been around for about.

10, 15 years. And that’s just like the general concept of that it could even happen. We’re still now starting to get that, like it’s a lot more than we originally appreciated. A recent study a couple years came out looking at serotonin, which we know is, plays a huge role in mood and, and neurological communications and things like that.

90% of the serotonin in our body is made in our. So something that we know is a building block to kind of bring communication and it’s really important. Most of it’s coming from our gut, so now I think we’re kind of backing up and trying to understand, okay, so like what is being created, what bacteria plays, The biggest role in that.

And some of the big ones, of course, serotonin, neuro epinephrine and dopamine, glutamate, gaba, all of them seem to be highly produced in the gut. But we’re just getting at that these pathways really exist. So I think. . I think in the next couple of years we’ll have a better understanding, but we’re at the point now, we’re still learning what bacteria are there and what it looks like when one bacteria is missing and you’re looking at, there’s like a hundred trillion from bacteria in the gut.

So it’s a huge, like even just. We’re just getting to the ability to even look at it because the methods to look at this are only now being created. So that’s why things are changing so quickly because how we used to look at these, you couldn’t look at all of it. So now you have things like kind of machine learning and stuff coming into play of being able to take these huge data sets and make them make sense.

So it’s a, it’s a fields that will continue to grow quickly, I think. But it’s all kind of, we’re all in the cusp of just getting it. That’s great.

So I, you know, I have talked on the podcast about c diff and how they are doing fecal transplants for that. And my understanding coming away from that podcast was, it’s harder to become a fecal donor than it is to get into Harvard Law.

So can you talk about safety and how you guys are screening your donors and Yeah. And that

process. So donor screening is the most important thing I think when it comes to fmt because you’re relying on what the donor’s gut microbiome looks like. There are some really early initial studies looking in, in animal models, but like the having obesity.

Transferring the gut microbiome can transfer those obese tendencies over. So we know it’s really important to know what you’re getting. So the way that donor screening’s broken down, the first thing you do is initial screening. That’s your health screening, your family health history. Just to get an understanding of, is there anything in your gut that could possibly be transferred?

We don’t know if it could be, but we do everything. So there’s some published standard. And in those cases, about 50 to 90% of people don’t make it past the initial screening. We actually have higher standards than what’s, what’s, what’s normally kind of put into place. So outside of just looking at different disorders and things that could be transferred, we also none of our donors could have ever had antibiotics in their entire life.

We know antibiotics can have a huge impact on the gut microbiome. Normally you’re looking at three to six. Of not having antibiotics, we’ve chosen to go with never having it. All of our donors are vaginally born because we know that that’s kind of the beginning or the building blocks of the gut microbiome.

And there’s a huge shift in different modes of delivery. As well as all of our donors are physically active and we, and every time they donate, we look at what they’ve eaten in the last couple of days to ensure that it’s kind of a widely diverse diet. Cause we know that diet can. The gut microbiome in 24 hours.

So we’re making sure that on that day, that we know that their, their gut microbiome is the best that it could be. Going through our initial screening, I get through like four questions and I’m out. And I’m like generally a healthy human being. And so it really gives you an appreciation of if, how stringent it is to be able to be a donor.

If you get past the initial screening, then you have blood and stool screening done and you’re looking at it. We look at about 120 different factors within blood and stool to, you have to pass all of those and the, you get retested blood. Stool screening every three months. And so what we’re doing here is basically everything that we can control and get an understanding of and something that is so diverse.

We try to put as many kind of controls in there to ensure that, you know, nothing is gonna be transferred to a patient that could then, you know, hinder their ability to get better or really get a full, kind of all the benefits out of getting f m. Outside of that in safety, we do a lot of work with product manufacturing which sounds a lot less cool, but it’s really important because.

What you’re doing here is consistency in how you make a product is really important cuz you wanna be able to, it’s the same with food. You wanna be able to know that every time you go and get that packaged food you like, it tastes the same and it cooks the same. That’s kind of what we’re doing with fmt.

So we’re using pharmaceutical grade standards in a pharmaceutical grade laboratory to create these capsules and, and these enemas. And that’s a really important thing and that’s where the field is headed, is kind of making sure that. , everything is done just like you would create any other type of drug that someone’s gonna take to ensure that all of the safeguards are in place to, in, to make sure that no one’s gonna get sicker or everybody’s gonna get what they, you know, they’re what they know they’re doing when they’re doing F M D.

Got

it. Okay. And then, so, Let’s say there’s somebody out out there that’s like, oh, this would be perfect for my child. So what does that process look like for someone who is interested in

this? Yeah, so we have four treatment locations. So we partner with we partner with facilities that have the medical staff and the capabilities, and then we provide product at a treatment protocol for them.

So we have a group in Hungary, in Panama, in Mexico and Australia. So those are the four countries that we provide treatment out of. And anyone that’s interested, the way that our program works is you can go to our website, it’s, gives you all the information you could possibly ever wanna know about F M T right from, you know, the history behind it, up to how we, we currently do F M T and then you can book a phone call to talk with someone on our team.

You can’t actually book a treatment on our website. We wanna ensure that there’s a conversation. People fully understand what they’re, they’re kind of looking into and make sure that all their questions are answered to try tofor, provide the most kind of transparent and informed PR process for every parent or every person that wants to try to look into fmt.

So they can just go to our website, book a call, and then they can have a conversation about it, ask all the questions they have, and so that they can get a full understanding of what we do and why we’re doing it. And if it. Fit. It won’t be a fit for everybody. We wanna make sure that everyone’s understanding of what can happen, everybody’s understanding of what the outcomes look like and where we’re at scientifically is everybody has that understanding.

Got it.

And what is, can you also, just to wrap up here, can you tell where people can get in contact? What was the name of that?

Yeah, it’s novel bio, so N O V E L B i O M e.com. And. The only caveat is we don’t treat Canadians. So Canadians can’t access our website and they can’t book any treatments.

That’s in conjunction with the governing health body in Canada. But outside of that, everyone can, can go and take a look and, and kind of get an understanding of, you know, what it is. And we try to be as educational as possible. We have a YouTube channel, which we just like, basically is like explaining all of the questions that people tend to.

And just trying to supply information cuz this is a really important, I think, new treatment option, but it’s one that I think comes with a lot of questions and, and people wanting to understand why it could work. And it works. It works kind of in a mysterious way. We don’t understand fully right now what the mechanism, mechanism of action or how it works is, so we’re trying to give people as much information as we can.

That’s great. Well, thank you so much for being here and sharing your knowledge and and sharing kind of the, the breakthroughs of this new treatment.

Thank you.

Thank you for listening to the Gut Health Reset podcast. Please make sure you subscribe, leave a rating and a review so more people can hear about the podcast. And hey, take a screenshot of this episode and. Annemarie on Instagram or Facebook at Dr. Annemarie barter. And for more resources, just visit drannemarie barter.com.