Fecal Microbiota Transplant: Is it Helpful for Candida?

A deep dive into the use of FMT for improving the gut microbiota, reducing sugar cravings, and healing other non-digestive symptoms with Enid Taylor

Over 15 years ago, Enid Taylor founded the Taymount Clinic, which originally focused on gut health and colonic hydrotherapy. Flash forward to 2011, her clinic became the first in the northern hemisphere to specialize in Fecal Microbiota Transplant (FMT). In this episode, Enid Taylor shares how FMT became a main staple in her practice, what criteria she uses to determine who’s a good candidate for it, and what other health conditions beyond candida it’s helped her patients with. Listen in to hear the surprising benefits of FMT for gut and overall health.

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Intro:

Welcome to Dr. Ruscio, DC radio, providing practical and science-based solutions to feeling your best. To stay up to date on the latest topics, as well as all of our prior episodes, make sure to subscribe in your podcast player. For weekly updates, visit DrRuscio.com. That’s DRRUSCIO.com. The following discussion is for educational purposes only and is not intended to diagnose or treat any disease. Please do not apply any of this information without first speaking with your doctor. Now let’s head to the show.

Dr Ruscio, DC:

Hey, everyone. Today I spoke with Enid Taylor. She is the wife of Glenn Taylor from the Taymount Clinic. Glenn Taylor had been on the podcast maybe three years ago. And the Taymount Clinic in the UK specializes in FMT, fecal microbial transplant therapy. And I wanted to revisit this therapy with her briefly and also talk about a protocol they’ve been developing for candida, just as a general exploration of what they’re doing, what they’re seeing.

Dr Ruscio, DC:

And this was an interesting conversation. I think high-level, Enid and I are on the same page in trying to bring natural and gut health-centric therapies to a broader audience. Epistemologically, I think we’re a little different in how we’re evaluating information and deciding what’s an observation worth using [and] what’s maybe not. And you’ll see that when we get into some of the particulars in terms of how and when they’re determining if someone does have a fungal problem versus does not based upon symptoms based upon testing. So it was an interesting back and forth on some areas where, again, I think we were evaluating information differently. But all that said, same team, but with different approaches. So we talk about FMT, we talk about candida, how one can look for symptoms demonstrative of candida, what lab values or markers can be used to diagnose or loosely infer there is candida present, and wove back and forth onto the topic of FMT. So that is the long short.

Dr Ruscio, DC:

As a reminder, if you need help with your gut health, “Healthy Gut, Healthy You”, I spent about three years pouring everything I knew into a self-help guide. So if you are in need of help, please pick up a copy of “Healthy Gut, Healthy You” and go through the self-help protocol. And with that, we’ll go to the conversation with Enid Taylor from the Taymount Clinic.

Where Does an FMT Fit in the Treatment Plan? It Depends

Dr Ruscio, DC:

Hey everyone, and welcome back to Dr. Ruscio, DC Radio. This is Dr. Ruscio, DC today here with Enid Taylor, and she is from the Taymount Clinic. And over there they do FMT. And we spoke with her husband a while back of regarding the work being done at the Taymount Clinic, and I came across a protocol that you guys have put together for fungus. It seemed interesting, so that felt like a good prompt to reach back out, connect with you guys, and talk about two things really—FMT and how the work at the Taymount Mount Clinic is going. And also any interesting insights from this fungal protocol. So Enid, it’s great to have you here and it’s love that you guys are helping to make FMT more available for people.

Dr Ruscio, DC:

You know, I’ve voiced in the past on the podcast that I’m wary of people doing this too early in their journey, if you will. I think there’s some low-hanging fruit we should explore first. But from there, for people who are having a hard time with response, I see FMT as being a way better option, let’s say, for inflammatory bowel disease that’s not responding to things like dietary changes and probiotics. And instead of them going on some sort of immunosuppressive drug, I’d much rather see them do an FMT. So really appreciate the fact that you guys are working to make this more available for people.

Enid Taylor:

Right. Yeah. Hello Michael. Thank you very much for inviting me to come along and talk. Nice to be here. Thanks. Your introduction there has raised a couple of things. We have a very eminent gastroenterologist Dr. Jeremy Sanderson. He’s like the go-to on conventional approach to gastro issues. And we were very pleased to hear him say one day that when he has patients presenting to him, there’s a sort of white noise of symptoms, and it’s difficult for him to know what symptom is the most, the most important, the one to attend to. So his theory was that everybody should have FMT, initially, as a first resort to wipe out some of these white noise symptoms and leave maybe the hardcore of symptomology that needs to be looked at in more depth. And I thought that was a very interesting approach.

Enid Taylor:

But certainly we screen patients before they can book into the clinic because we need to make sure, as you say, there isn’t a problem that needs to be looked at or put right first. I’m thinking particularly if things like SIBO (small intestinal bacterial overgrowth) or as we are talking about candid albicans. It is difficult to know how many things you should look at first when FMT does seem to put right a lot of things and we don’t quite understand exactly how it’s working. We have a wonderful association with Professor Thomas Borody, who’s in Sydney, Australia. We consider him to be the godfather of FMT. He was quietly doing it for 20 years before we stepped into the space and he said that he does get good results with patients who’ve got SIBO confirmed with hydrogen methane breath tests, but he’s not quite sure what biological pathways are involved in introducing a balanced microbiome at the sort of the bottom end of the system—why that has such a beneficial effect further up, why does it go back against the flow of digestion. We’re not totally sure.

Enid Taylor:

We had a beautiful patient and she was coming to us for a digestive issue, but she mentioned that her lovely white teeth grew a sort of green sort of skin every six to eight weeks. And she had tried everything to get rid of this herself and had to go to her dental surgeon every couple of months to have a scale and polish to get rid of this green overgrowth. We now know it was Streptococcus viridans. […] But anyway, we did the FMT with her for her digestive issues and lo and behold, the green coat just did not recur. And she was kind enough to do a sort of talking head testimonial video for us. And she is a very attractive young lady with these beautiful white teeth. So it was hard to imagine what was happening. And again, we don’t know if introducing a new microbiome, the sort of the last stages of the digestive tract, does it form a sort of biofilm that it can transfer toxins or whatever through quickly? Is it a conversation with her immune system that then has an effect somatically? We just don’t really know.

Dr Ruscio, DC:

Yeah, I mean a lot there to respond to. I would agree with the gastroenterologist you referenced who likes the idea of trying to get rid of the white noise. Definitely. And this is an analogy we use at the clinic where we often will describe the plan that we construct for someone analogous to this tree model where we start with the trunk of the tree and then we see what, if any, symptomatic branches are still present. And the trunk is encapsulated by what we term the diet, lifestyle, and gut health foundations. And once we improve diet, lifestyle and gut health, many of the branches of symptoms—brain fog, skin issues, maybe periodontitis, maybe PMS, hot flashing, whatever it may be—many of those branches, if not all of them, will go away. Except for, perhaps, there’s one or two symptoms or a cluster of symptoms, aka a branch that hasn’t responded. And then we can be more directed in our approach.

Dr Ruscio, DC:

The only spot I would push back is, I don’t know that FMT needs to be administered first. That’s where I think, and this is fine, we’re not always going to agree on all things in different realms of healthcare and we bring our respective biases to these, but I’d rather see someone use things like probiotics or elemental diets or trial a low FODMAP diet then jump to FMT. But nevertheless, I think we’re seeing eye to eye in the sense that we want to start with gut health and see how many symptoms will resolve themselves once we address that.

Enid Taylor:

Yeah, I think it’s important to try and establish whether this person in front of you actually ever did have a good healthy microbiome. And it can be quite a surprise to realize that it takes two to three years to develop a full spectrum of microbiota. So you’re not going to be developing until you’re at least three years old, two to three years old. And then there are a number of factors that can actually prevent you from even getting there then. We always quiz our patients, “what was your mother’s health like? What was your delivery? Where you were a c-section baby, where you were a normal delivery? Did you have lots of antibiotics as a child?” So it could be that that person never ever got a full spectrum of microbes.

Enid Taylor:

And I, my personal theory, is that around about the age of 19 or 20, your human growth hormone levels start to drop. And it’s a protective effect of youth, I suppose. And the sort of the shortcoming is the microbiome start to reveal themselves when the protective hormone is removing. So I mean, you’ll find that most things like Ulcerative colitis and other IBDs tend to start sort of late teenagers, sort of consistent with my theory. But yes, it’s pointless trying to get somebody to augment a microbiome that was deficient from the start. We are an island, unless you bring it in, it’s not going to be there.

The Creation of a Fungal Protocol

Dr Ruscio, DC:

Well, certainly we’re not starting where we probably should be. It’s more likely a a slowly deficient start. So let me, ask you just to maybe come over to the topic of fungus for a moment. What was the inception of a fungal protocol? Was there a lab marker that you were running maybe pre and post, where you were noticing a correlation between not fully responding to FMT and this fungal marker? Or how did you find your way to fungus being something that you’re particularly singling out in some of these cases?

Enid Taylor:

It predates FMT, actually, because my early days of naturopathic clinic, I mean, I qualified in 2002, so 2003 I was seeing people. And typically ladies are plagued with candida albicans overgrowth. It seems to be a very female thing. There’s a lot of attention on the gut and what happens when you’re on antibiotics or repeated antibiotics, but of course wiping out any pathogens with antibiotics has an effect on all the microbiota, the nose, the ears, and of course the vaginal passage. So a lot of ladies were suffering from ccandida albicans overgrowth because they’d been on unrelated issues for antibiotics. But I found that when I first started to look at the whole health and natural health arena way before I qualified, it wasn’t even easy to get your GP or doctor to even believe in candida albicans overgrowth.

Enid Taylor:

And I get quite annoyed when I hear people say, “my doctor doesn’t believe.” And I think, well, if I wanted belief, I’d go to the church. When I go to the doctor, I want science. And the science is there, that you have an overgrowth of yeast if you have an imbalance. So it started from a frustration that the ladies I was seeing weren’t being treated sympathetically, and the treatment they were offered just wasn’t working. Often we found that things like the antifungal, Nystatin, and drugs—I don’t know what they’re called in the US—but there’s a group of antifungal drugs that are now prescribed. And yes, they will give temporary relief, but we’ve discovered—I think you’ve read the protocol sheet—we’ve discovered why that relief is only temporary, and what happens when you start administering some antifungal regime and why as soon as you finish the treatment you get a recurrence. Do you want me to sort of go into that?

Dr Ruscio, DC:

Well, I want to push back a little bit because the “diagnosis” of candida, it’s not super straightforward. And just seeing candida albicans +1 or +2 on a stool test, in my mind, is not diagnostic of an overgrowth.

Enid Taylor:

No, I agree.

Dr Ruscio, DC:

You know, some lab consultants will confirm that, some may not. We’ve also done a review on this, and even with the best testing, meaning whatever test, whether it be a blood antibody test or a stool test, even looking at the studies there that have attempted to assess this, the read in terms of the diagnostic ability for whatever marker to correctly diagnose or discriminate healthy controls from those with fungus, it’s pretty poor at best. And I say this as someone who’s trying to get a handle on this, and we’re currently running an antibody profile on all patients to see if there’s an agreement between symptomatic presentation demonstrative of candida and this antibody profile. So, yeah, I mean, I would push back there a little bit in that I don’t know if it’s fully correct to, you know, claim candida overgrowth is so problematic if we have no way of actually quantifying that.

Enid Taylor:

Well, I totally agree. We find that testing brings its own problems. And we do believe that if you look for something, you’ll find it. There’s an idea, even held by some of the medical profession here, that a healthy gut is one that’s got no pathogens. Well, that’s impossible. A healthy gut is one where you’ve probably got all known pathogens in some number, but they are in balance. And that’s the whole secret of a comfortable, healthy lifestyle is everything in balance. It’s like a healthy society isn’t one where there’s absolutely no criminals. It’s one where there’s a very, very small number of criminals, an adequate number of police, and everybody else living an obedient lifestyle. Same happens in your micro sort of world, that a healthy gut is not one that is absolutely devoid of pathogens, it’s one where everything is in suitable numbers to keep everything in balance.

Enid Taylor:

So if you go looking for candid albicans, you will find it. If you go looking for any of the other pathogens—we have a list of about 21 that we have to test for—and yes, you will probably find them. But it’s what symptoms is the patient presenting to you? What clinical condition are they in? Does the list of symptoms match the list of symptoms you are looking for in a candidate albicans overgrowth situation? So it very much depends on how the person is presenting, I think. Yes. I mean, testing tends to bring its own problems.

Dr Ruscio, DC:

Yes. In full agreement with you there. Yeah. I think you make a great point, just to echo this for our audience, that if you run lots of testing on people, you will find lots of positives. And if those positives don’t discriminate those who have a certain cluster of symptoms or a condition against healthy people without those symptoms, then the testing can really lead you astray because now you’re treating what we could loosely term a false positive. So I love the fact that you’re speaking to symptoms.

Potential Symptoms of Candida or Fungus

Dr Ruscio, DC:

What symptoms are you looking to as demonstrative of having a problem with candida or with fungus in general?

Enid Taylor:

Yeah, it’s a syndrome. It’s a collection of symptoms and there’s so many overlaps that it is sometimes difficult. Things like brain fog. With candid albicans, you can even go as far as flu-like symptoms with joint pain, muscle aches, obviously localized itching, and rashes can be highly indicative. But it is such a wide range. I think there’s a book, actually, that I remember reading a long time ago, so it’s been out about 30–40 years called the “Yeast Syndrome,” and the list of symptoms there was pretty long. And it’s almost like, well how many of these does everybody have from time to time?

Dr Ruscio, DC:

Yeah. So if I could interject one thing here, this is why we fall into a pattern of creating for each individual a therapeutic hierarchy. And we want to strike this balance where we use symptoms to inform treatment, yes. But we also want to understand, coming back to that tree analogy, that if we focus the personalization of the therapeutics to that trunk of the tree, their diet, their lifestyle, and their gut health, then so many of these symptoms will remedy themselves. Because to your point, hypothyroid, yeast, SIBO, anemia, those all have a tremendous amount of symptomatic overlap. Which is why, for us, we use the symptoms, yes, but there’s also this, “well what therapies are the safest, the most well studied and are treating dysfunction as far upstream as possible?” And that’s why we tend to start there and then see what, if any, symptoms are still standing. Again, to your point, because there’s so much overlap between the cause of something like brain fog, for example.

Enid Taylor:

Yeah, there is. I mean, isn’t it amazing how many things you can eradicate just with good diet and a healthy lifestyle?

Dr Ruscio, DC:

Right? Yeah.

Enid Taylor:

We have friend at the moment, a guy, he’s a builder actually, and he’s really, he’s our age, in mid sixties and he’s having trouble just getting out of his vehicle. He’s got a very bad knee, he’s got no cartilage left. They won’t put him on the waiting list for a knee replacement because he’s too heavy and he’s diabetic. And I just think, “Oh, where do I start?” I’ve given him a video, “Solve diabetes in 30 days with the raw diet,” something like that. And I’m just waiting for him to come roaring back at me because I know he hasn’t watched it yet. There will be some pushback as you say. But I know that this gentleman, he could change his entire condition in just 30 days of eating a really therapeutic diet. And I’m poised like a coiled spring ready to help, but you can’t help somebody unless they’re ready.

Dr Ruscio, DC:

Yeah, no, I know that that frustration all too well. […] So maybe if I can throw out a few of the symptoms that I’m starting to hone in on as what I think could be indicative of a fungal overgrowth and then see how this maps onto what signal you guys are getting over at the clinic? Thrush would be one obvious one. If someone has too much carbohydrate or sugars, whatever form, whether it’s processed sugar or something like bananas, they are prone to getting this white coating on their tongue. Along with some other very upper GI symptoms like post-nasal drip congestion. And especially if you notice any of those symptoms tend to be flared by starches, fruits and/or processed carbs or sugar. That consolation to me, seems to be the most tightly correlating with those for whom I think we have to pivot to specifically antifungal therapies, sometimes with anti-biofilm agents, sometimes with nasal spray probiotics, and/or nasal spray anti-biofilm agents.

Enid Taylor:

That’s quite drastic. I would also look for somebody who’s drinking a lot of alcohol, especially the sweet sticky sort of stuff that they’re marketing women and teenagers. I think the amount of alcohol that women particularly are drinking now is so much greater than it was when I first started practicing. We have a sort of a societal dependence on alcohol as a great numbing agent. And that I think is bringing a lot more carbohydrate and sugar into the diet. Probably not even considered to be sugar. People don’t think about what they’re drinking so much.

Dr Ruscio, DC:

Right. Well, and that would fit in with my hypothesis, right? If someone reports these symptoms, like if I drink any alcohol, I’ll notice my tongue gets white, I have postnasal drip, maybe I have a rash. So certainly I would put underneath the umbrella of, you know, carbs, something like alcohol. Definitely.

Enid Taylor:

And we’ve had this low fat nonsense for the last 40 years, which means everyone’s been eating more and more carbs. And carbohydrates are quite addictive. I mean, they actually call it “bread head”, don’t they? If you start eating bread and wheat based foods, they are opiates. They are slightly addictive. And there’s a very sort of addictive nature about the sweets and the sugars that people are eating when they are full of some yeast or fungal overgrowth.. it drives them to seek more of the food that those microbes need.

Dr Ruscio, DC:

So that would be one symptom you would put on the checklist. And maybe the checklist you don’t agree with, you don’t think they are symptoms, but just trying to get from you. Are there any symptoms that you go, “this is indicative of a problem with fungus”. Alcohol is one, maybe the cravings would be another?

Enid Taylor:

Yes. Definitely sugar cravings. Unbalanced food cravings. And then things like headaches. People are like, a lot of migraine type headaches can be caused by the sugars that people are eating. And we don’t know whether that’s the actual yeast causing it or the sugar. Migraine’s still a bit of a mystery to medical science, which is a shame. But yes, I think the biggest one for me is the sugar craving. If people then try not to, and then they find they can’t. So this condition is actually driving their behavior and pushing them further away from what we would consider to be a healthy diet.

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Making Sure the Stage is Set for FMT

Dr Ruscio, DC:

Now, when you pivot over to the use of this essentially herbal protocol for candida, what responses are you typically seeing? Because when I zoom out and consider the response curve of a patient, there’s a couple of things I take into account. How quickly should we be seeing some symptomatic improvement? Is there any risk of reaction? And how do we troubleshoot if this is a die-off reaction or this is an intolerance reaction? And then at what point should we expect to see a therapeutic plateau and what do we do when we see that plateau?

Dr Ruscio, DC:

So there’s a few things I look for: How quickly do they respond? How strong do they respond? Where do they plateau? And then how do we troubleshoot either with getting out agents that they may be reacting to and or going to maybe a level two protocol if we plateaued insufficient of our goal, which is predominant resolution—I wouldn’t say perfect. It’s hard to ever get the perfect—but I think we’re looking for a 80/90% response rate. So how do you look at the fungal protocol, the response curve if you will, or just evaluate if someone’s on the right track?

Enid Taylor:

Well, we tend to say that this has got to be followed for at least a month and ideally two. Because we are almost saying you can’t come for FMT if we suspect that the presenting problem is either shielded or heralded by candida or fungal overgrowth. We will say that they must do the Candida albicans protocol before they come for FMT. So they’re highly motivated because they’ve decided they want to come for FMT. Part of what we do is expectation management. It’s a very big part of it because I don’t want people just turning up thinking that FMT is going to be the answer to everything. So we will push them back and say, “well you can come for FMT, but only once you’ve done the anti-candida treatment.” So motivation is high, compliance is pretty good.

Enid Taylor:

And then I suppose what we’re doing is we’re actually compounding our variables a little bit because yes, by the time they come for FMT maybe two months from this initial consultation, they are much improved. And then we do FMT, which tends to improve a lot of other things anyway. So it’s difficult to know whether the anti-candida protocol has actually stopped any recurrence or whether it’s the anti-candida protocol and then FMT, which is just like a blanket approach and dealt with everything. But we certainly we don’t get a recurrence of candida, we get quite good adherence. And I haven’t actually experienced anybody saying I’m allergic to the oregano or I’m allergic to gymnema. It doesn’t seem to cause that. I think as I said, they’re highly motivated and their sights are on the long term FMT that they want. It’s almost like they’re not concentrating too much on the candida.

Dr Ruscio, DC:

So help me understand, because there seems to be a slight contradiction with the earlier statement about how do the FMT early get rid of the noise. It can be such a powerful respondent therapy to, in some cases, doing herbals first. What’s the thinking behind that?

Enid Taylor:

Well, that was a conventional gastroenterologist talking about FMT.

Dr Ruscio, DC:

Okay. So not necessarily how you’re…Well I’m assuming you’re thinking about it in a very similar vein, if you’re doing FMT as the therapy that you’re starting with in, I’m assuming, most of the patients that you see.

Enid Taylor:

Yeah, we don’t plow straight in with it in every case. So there are some things that we like to clear up first. For example, I’ve got a patient who wants to come in October, but I’m not entirely convinced there isn’t something, maybe Barrett’s esophagus, there. So I’m not going to let him come into the clinic until he has had an endoscopy, because no amount of FMT would put right Barrett’s esophagus, I don’t think.

Enid Taylor:

Anyway, so I don’t want to start FMT until the physical examination has been done. And any, I mean mean Barrett’s esophagus is often put right with surgery, so that would need to be done before anything else micro biological would come in. So it’s not always a case of it’s the first resort. But it was a nice thing to hear from a conventional, medically trained specialist that he thinks FMT is that important, that it shouldn’t be left to the last possible resort when everything else has been tried.

Dr Ruscio, DC:

Well, so one, one quick note there. Not to cut off your flow, but, you know, if I had a nickel for every time a patient came in and said they’ve tried everything, I’d be a rich man. So I do think it’s important to know that we try everything that we know about. But you know, if your circle of influence or reading only encapsulates 20% of the available therapies for the gut, then you’ve done everything that you know about, but one clinician with a broader purview over the therapeutic repertoire could, as we so often do at the clinic, help someone who thinks that they’ve exhausted all of their options.

Enid Taylor:

It is often the options on offer from conventional medicine that they’ve exhausted. I get so cross and so frustrated when a patient will say to me, “Well, my doctor’s done this, has done colonoscopy, he’s done endoscopy, he’s done this and the other, and there’s nothing there. They can’t see anything.” So I’m tapping the desk thinking, well, if they can’t see it, then perhaps it’s microscopic. But they don’t want to make that leap. They don’t want to consider that. If it’s not a structure in front of them all that their cameras can look at, then they don’t know what it is. Why can’t they think that we are not just physically visible, we are microscopically functioning as well. I mean, life itself begins on a level that’s invisible to the the human eye. And that’s pretty powerful stuff. I mean, the act of conception is incredible, but we can’t see it.

Dr Ruscio, DC:

And one of the things that we we’ll respond to when a patient says that is like, “yay, right? This is good. So there’s no major medical pathology present. This tells us it’s something more within the functional camp that can be addressed with diet, lifestyle, [and] modulation of the microbiome.”

Enid Taylor:

Yeah. Yeah. It means nothing is structurally changed or damaged or altered that cannot be put right, as you say, with proper feeding. And maybe it comes down to the old adage that there’s only sort of one disease, it’s toxicity and deficiency in different numbers. So you stop the poisoning and you bring back good nutrition. That’s basically what we try and do with them.

Why FMT Isn’t the First Step

Dr Ruscio, DC:

Right. So coming back to my question from a moment ago, maybe I can pose this a different way, which is what led to not having patients with a certain cluster of symptoms start with FMT? Because I’m assuming maybe that a certain cluster of symptoms that seem to map on to candida were not responding well to the FMT and this is why you now have them front load, essentially, with an herbal antimicrobial/antifungal protocol? Or, you know, is there some other observation backstory there that led you to this deviation?

Enid Taylor:

Well, I think I’m obviously an absolute died-in-the-wool FMT fan, or what you want to call it, because we have seen some amazing things happen just by redressing the gut flora balance. It just seems to have a system-wide effect. So I’m of the mind that if you did FMT, you would probably redress the Candida albicans overgrowth as well. But if it’s pretty obvious, and maybe it’s even been diagnosed by a previous professional, that a patient has candida overgrowth, has a fungal infection, and there are some tests that we can do that actually hone in on that (as we said, if you look for it, if you test for it, you’ll find it), if it’s an issue and it’s glaringly obvious that there are symptoms presenting that do conform to the candida protocol, the candida sort of syndrome, then I think it’s good practice to try something as noninvasive as the protocol that we’ve put together—killing the hyphae, killing the yeast bodies, mopping up the Herxheimer effect and supporting body through that whilst they’re waiting for their FMT…

Enid Taylor:

I mean, we have a waiting list of about six weeks, I think, at the moment. And it’s a good use of those six weeks to prepare in a number of different ways. So yeah. And it isn’t a one size fits all. I mean, we very much go by what we’ve discussed during their 45-minute initial screening consultation. It is difficult to sort of make rules because every person is different.

Dr Ruscio, DC:

There was, to my recollection, it may have been a meta-analysis or was at least a clinical trial, that found antibiotic treatment before an FMT improved the efficacy of the FMT. And it sounds like this is a similar approach. You know, I would argue that the candida, with all due respect, sounds, is a bit of a red herring. I’m not seeing what you’re seeing, but it doesn’t seem to me like there’s a really concrete case from a symptom or a biomarker perspective to denote the need to front load. You know, feel free to push back on that. But the lab testing is not super accurate.

The Role of Antibiotics

Dr Ruscio, DC:

And if there’s so much overlap between candida symptoms and other symptoms that could be driven from the GI then how can we really say if there’s a candida problem or maybe it’s just a SIBO problem, or maybe it’s just a dysbiosis problem? But I do think there’s value in what you’re doing from the perspective of there does seem to be at least some evidence, and maybe you know this body of literature better than I do in terms of the studies that have looked at, antibiotic therapy before FMT. But from what I recall, there’s a more favorable outcome when patients are front loaded with some sort of either antibiotic or in this case herbal antimicrobial protocol.

Enid Taylor:

Yeah, I kind of winced a little bit about that because like I said earlier, you’re not just cleaning up the gut flora. When you use a systemic antibiotic, you are altering the microbiome balance in every cavity in the body. So if you are preparing to do FMT and you give antibiotics to sort of clean the bowel, you’ve also upset the vaginal microbiome, you’ve upset the nasal, the ears, you’ve upset the balance of the body everywhere. So I think antibiotics should be very much something that you turn to when you really need them, not a prophylactic or a preparatory.

Enid Taylor:

If there’s no infection, why use an antibiotic when what you’re doing is restoring a wonderful balance? And that has a beauty of its own. And I just think let the body do what it’s designed to do, give it the lovely balanced microbiome and let it sort itself out. And I’m not one to rush to the candida protocol. […] I find sometimes if people have specialized in something and they’ve studied something, that’s what they see every time. The SIBO aficionado will always find SIBO.

Dr Ruscio, DC:

No, you’re absolutely right about that. Yes.

Enid Taylor:

So it’s not something that I particularly look for all the time, but if a patient says to me, “I’ve been tested for candida, I’ve got candida,” then I will address that mainly to put their mind at rest and to sort of address that situation whilst they’re waiting for their FMT.

Dr Ruscio:

Well, certainly, I would agree with you that we shouldn’t be indiscriminately using antibiotics and that the herbal equivalents offer, I think, a much better starting point. Absolutely.

Enid Taylor:

There’s certainly more targeted—I mean, certainly antibiotics save lives and I would be the first to say we need them when we need them—but it’s the case of how do you determine when you need them? And I don’t think you need them as a precursor to FMT. What we do in the clinic, we do a stool softening program. You can either come for three consecutive days colonics to really sort of rinse, hydrate, and evacuate. And then day one of your FMT program is another colonic lavage. So we’re literally removing the bulk of the legacy material anyway. And then putting in 10 consecutive days, we put in the small (about 60 ml) of microbiota. So we are literally, I mean, FMT [and] probiotics is a numbers game. So if you can reduce the legacy material and introduce enough good stuff, then you’re going to have a beneficial result. And I don’t really feel that it’s, it’s right to put antibiotics where there is no life-threatening infection.

Dr Ruscio, DC:

I agree. And this is one of the themes that I developed in “Healthy Gut, Healthy You,” which is (well, there’s two parts of this comment), one is, while I agree with you that we should not be using antibiotics willy nilly, I also feel that the natural health community, which I include myself in, has gone a bit too far in their vilification of antibiotics. And there’s a balance here. Certainly the earlier in life they’re used, the more detrimental they can be. But I also can’t refute some of the really impressive data using certain antibiotics like Refaximin.

Enid Taylor:

Oh, yeah. Yeah.

Dr Ruscio, DC:

And even more broadly, you know, certain disease cohorts like IBS and IBD will show benefit from administration of antibiotics. Now sometimes those results are short lived. And this is where the other part of my comment comes in, where we developed this hypothesis in “Healthy Gut, Healthy You,” which is if you get the right inputs to the microbiota set, namely the diet, lifestyle and gut health foundations that we always reference, then these things like exercise, circadian rhythm, stress management, appropriate diet, time in the sun, and therefore the vitamin degeneration, all of these inputs have been shown to have a favorable impact on the microbiota.

Dr Ruscio, DC:

So if we get all these supports in place first, and now the microbiota, it’s healthier than it’s ever been, presumably, but maybe there’s still some residual imbalance, this is when a nudge from either antimicrobial therapy or antibiotic therapy can be administered. And because we have all these healthy supports in place, it gives us the highest probability that after that antimicrobial antibiotic nudge, we’ll see a resetting to the optimal equilibrium, which is why we’re a big fan of sequencing therapies and then leaving something like herbal antimicrobials or antibiotics or also FMT a bit more to end-phase because we should have a better favorable long term outcome if we get those healthy microbia inputs in place first.

Enid Taylor:

Yeah. It’s almost a case of first and last, I think perhaps. I mean, to me, the ideal situation would be a wonderful deep cleansing detox clinic on a cellular level using IV vitamins and Phosphatidylcholine and Glutathione, and then finishing with FMT. Just to go back a little bit to what we were saying about antibiotics, my youngest daughter developed Crohn’s at the age of 19. Now, she was about three years ahead of my progress through my training so I learned from her rather than was able to help her, which is a shame. When she got to 30, she had the most catastrophic event. She she was actually in hospital at the time and her bowel ruptured. And that taught me that there’s no such thing as good or bad bacteria. That sort of oversimplification just is irrelevant because even the “good bacteria” if it’s outside of the colon, it’s life threatening.

Enid Taylor:

And we very much nearly did lose her. She had peritonitis and sepsis, lost half a bowel. So bless her heart, she’s been a sort of active physical teaching aid for me. And I was just never ahead of the game enough to help her. She did end up having FMT, but after she’d lost half her colon, she had a colostomy bag. So it was pretty terrible. And without antibiotics we would’ve lost her. She actually went through the whole gamut of antibiotics. I think she ended up with carbapenem, the last resort almost.

Enid Taylor:

So I’m very much in favor of antibiotics when we need them because it does save lives. And I’m just wondering in the studies that had antibiotics as a remedy, I mean, I know they treat clostridium difficile with antibiotics, and it does seem to have an effect initially, but these clostridia, they actually have like a six-week cycle and you can only kill them at certain stage in their cycle. So if you administer antibiotics at the right time, you kill a whole load. But there are others that may still be in their spore form and then six weeks later you get a recurrence.

Enid Taylor:

So antibiotics alone doesn’t knock out something like clostridia difficile. So again, I just don’t think there’s one weapon to use. I think it’s the whole arsenal of weapons that we need. And it’s trying decide which order for which person I think is what your whole approach you have is. You know, what do I need with this patient? What do I need to start with? What do I need to finish with? What do I need the most of? And that is really done in the moment with the patient.

Dr Ruscio, DC:

Well, it’s part of the art of medicine, I guess. I mean, a lot of it is occurring against a framework that’s informed from biostats, what conditions are the most common. And if three different conditions have very similar symptomatic overlap but one affects 35% of the population and another affects 0.5% of the population, we’ll start with the 35% probability and then work our way down. So there is that, and then we juxtapose that with their history. Have you been treated for the 30% syndrome five times and never responded? Okay. You know, we’re not going to do that anymore. So, there’s a few different variables that we weight conjunctively.

Surprising Symptoms That Have Responded to FMT

Dr Ruscio, DC:

One thing I want to make sure to ask you, and maybe there’s just too many observations to pull from but if any stand out I’d be curious to pick your brain on this, what are some symptoms that you’ve seen respond to FMT that you weren’t thinking would?

Enid Taylor:

Well, we have to be really, really cautious here because we are really not allowed to say that FMT has any effect on any particular condition. You know what regulators are like. I can give you some anecdotes. There was one really charming chap who came to us for a digestive issue and partway through his second week I met up with him and checked in with him. He said, “Oh my digestion’s really good now.” He said, “And my tremor in my right hand has stopped.” And I looked through his notes and I said, “There’s no mention here of a tremor in your right hand.” He said, “No, I didn’t mention it because it’s nothing to do with my stomach.”

Dr Ruscio, DC:

Don’t you love those?

Enid Taylor:

Yeah. That was wonderful. So we made a note of that, expanding our intake questionnaire to ask everything. So yes, we’ve seen things like a tremor subside. I’ve seen people who forgotten to take their rheumatoid arthritis medicine during this day because they’ve just woken up with no pain or forgotten to take their medicine. We had one charming lady who came to us from, I think she was in Holland, she came in one day in the second week and she said, “I can see leaves.” And we said, “Yes, it’s September, there’s a lot of leaves around.” She said, “No, no, no, no. I have birdshot choreo retinopathy.” I had to go look that up. And she said, “When I look at trees in the autumn I just see orange blobs,” but she said, “I’m walking to the clinic this morning and I can see leaves.”

Enid Taylor:

So we were lucky enough to have had her assessed by her ophthalmologist before she came as a routine. And then she went back to him afterwards and he measured the inflammatory markers again and they had, in fact, reduced. So her eye condition had responded during the time she was with us having FMT. That one was probably the most remote, I think.

Dr Ruscio, DC:

Yeah, very cool.

Enid Taylor:

But I think what we’re looking at is a general anti-inflammatory action and you know how many conditions are linked to inflammatory sort of status.

Dr Ruscio, DC:

Sure, and especially with the connection between the incredibly dense amount of immune cells in the intestines and how the immune system uses inflammation as one of its primary instruments of cleaning, if you will.

Enid Taylor:

Yeah, it’s like the conversation between your inner life and the outside world takes place in your gut because that is your interface with the outside world. People tend to think of the skin being the outside and the gut being the inside. And it’s not because we are like a hollow tube and the inside is across a membrane, you either have to cross the skin or cross the epithelium to get into the inner world. So our gut is the conversation area between our immune system and the outside world. So what we put in our gut is really the source of information for our body to learn from.

Dr Ruscio, DC:

Yep. Well said. I wish more people appreciated that. But I think pretty much everyone listening to this podcast is privy and hopefully sharing with their family and their friends what the source of many of their chronic nonresponsive symptoms could be.

Enid Taylor:

Well I can give a little example. If you have a child who swallows a marble…you call them marbles in America?

Dr Ruscio, DC:

Oh yeah.

Enid Taylor:

That marble will pass through in a day or two and come out the other end unscathed. It hasn’t gone into the child, it’s passed through the child. So there is no going into that child unless you cross a membrane on the inside.

Dr Ruscio, DC:

And that’s why we need these healthy membranes so we can absorb what we want and keep out what we don’t and don’t have a whole war of inflammation at that border.

Enid Taylor:

Yeah, totally. Right. Totally right.

Where to Find More From Enid Taylor and the Taymount Clinic

Dr Ruscio, DC:

Well, anyway, this has been a great conversation. Is there anything you want to mention in close and would you also let people know if they wanted to contact you where they can find out more?

Enid Taylor:

Yeah, the only thing is I found that with the candida protocol for many years we were looking at things like nystatin and antifungals, and it did have an effect in the beginning. When you take nystatin, you kill the yeast and you worry about not doing it too fast because of the die off. And it was a discovery that yeast has more than one form. And when things are threatening the yeast, when it’s either starving or it’s overgrowing and there’s too many of them, or you are bombing it with some antifungal, it will morph into a little strand-like tiny fine worm and borrow into the tissues. So instead of being in the lumen of the colon or the lumen of the vagina is actually borrowing into the tissues, into the interstitial spaces and hiding there until conditions are better and then will come back down for another attack.

Enid Taylor:

And that’s why when you are taking antifungals, you kill what’s left in the spaces, but you haven’t killed what’s hiding in the interstitial space. And it’s the gymnema, the gymnema sylvestra, that actually brings those hyphae back into a space, into a yeast body form, where you can literally kill them then with the antifungals. And the die off is mopped up by Molybdenum. That’s used in a lot of anti-hangover clinics because Molybdenum helps the body to break down alcohol and yeast gives off Acetaldehyde, which is a derivative of alcohol.

Enid Taylor:

So it’s the three pronged approach that makes more sense to us. So it’s not just an antifungal you need. You need an anti-hyphal sort of persuader to come to get these things to come back into a space where you can then kill them. And when you kill them, you can then just mop up the off with Molybdenum. So that’s why we had this three-pronged approach. That was a revolution to me because it explained why people kept getting recurrence of it and why it just seemed to come back each time.

Dr Ruscio, DC:

It’s similar to the Anti-biofilm. And I think these are different ways of saying the same thing, but [I’m] with you in the sense that sometimes an additional agent is needed to obtain full clearance. I’m still making up my mind on the utility of anti-biofilm agents, but it’s helpful to hear other people’s experiences. And it sounds like in your case, quite apparent was the benefit from the gymnema.

Enid Taylor:

Yeah, absolutely. And I’m very, very shy about using anti-biofilms. I think the biofilm is such a precious thing. It’s like the bloom on a piece of fruit. It’s there because nature wants it to be there. Our biofilm, as I said, I think it could be a transport mechanism that travels through the body pretty quickly, but to strip it down I think is a little bit dangerous unless you know exactly what you’re putting back in its place. So I’m nervous of tinkering with something so not fully understood.

Dr Ruscio, DC:

Sure. Yeah. No, I can appreciate that. Yeah.

Enid Taylor:

Yeah. So yes, if people want to talk to us about their gut issues and explore whether FMT is right for them, the website is taymount.com. That’s taymount.com. We do an initial screening consultation, which you can book yourself through the interface on the website. And as I said, it’s not for everybody. FMT isn’t the answer to everything. It can change lives, it can make an incredible difference to people, and I think what’s exciting for us watching it happen is not the clinical data, it’s the non-clinical sort of observations.

Enid Taylor:

People come bouncing in during week two, and they’ve got little apples in their cheeks. They’ve got a sparkle in their eyes. They’ve got energy coming from inside that they didn’t have before. And to a naturopath, that’s something that we can observe and talk about, but you can’t talk about that to conventional medicine. They don’t have a form with boxes they can fill in to talk about aura or energy or just somebody feeling more alive or having a better sense of humor. Those are the things that are really important to life. Not just the clinical observations, but the things that make life worth living.

Dr Ruscio, DC:

Sure. And this is, again, one of the reasons why we put so much emphasis on gut health is because you’ll see this multidimensional improvement: someone’s energy, their skin, maybe their sleep therefore their mood, also their cognition. And so now they walk in and they have more energy, they’re more optimistic, they maybe have enough cognition to make a witty joke or something like that. And it’s great to see that. Yeah.

Enid Taylor:

I think the people who come with them, I mean, I’ve had people say to me, “Thank you, I’ve got my husband back, and now I can go back to being his wife and not his carer.”

Dr Ruscio, DC:

Yeah.

Enid Taylor:

I mean that’s really, really…

Dr Ruscio, DC:

That’s fantastic.

Enid Taylor:

Yeah. And people get back to work. They get their jobs back, they get their lives back. It’s just incredible. Just from giving them what nature intended them to have. And we just, we have a sort of strap line we say, we’re just putting biology back to medicines.

Dr Ruscio, DC:

Yeah. I love it. I mean, as a gut devotee, I’m fully there with you. Yeah. Well, Enid, thank you so much for taking the time. And will you please send my best to Glenn?

Enid Taylor:

I’m willing to, yes.

Dr Ruscio, DC:

All right. Well, thank you again.

Enid Taylor:

Thank you very much.

Dr Ruscio, DC:

You also. Take care. Bye-Bye.

Enid Taylor:

Thanks. Bye bye.

Intro:

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