Getting a New Gut Microbiota via Fecal Transplant with Glenn Taylor

What do you do if nothing has worked to fix your gut?  One option is to get a new gut microbiota.  A fecal transplant is a technique wherein you can replace your gut bacteria with the gut bacteria of a healthy donor. Today we speak with a pioneer in fecal transplant therapy, Glenn Taylor of the Taymount clinic.

Dr. R’s Fast Facts

  • FMT or fecal microbiota transplant therapy is a therapy where you transplant stool from a healthy donor into a sick person in attempts to recolonize them with a healthier bacterial colony
  • Unlike probiotics, this technique can colonize the host
  • This can be good therapy once you have exhausted all other non-invasive options
  • How effective is FMT?
    • One systematic review with meta-analysis found
    • One Chinese study found, https://www.ncbi.nlm.nih.gov/pubmed/28105618 Trusted SourcePubMedGo to source
      • Clinical cure rate and improvement rate of different diseases receiving FMT were respectively as follows (non-controlled study);
        • RCDI was 85.2% and 95.1%
        • Constipation was 40.2% and 67.4%
        • Ulcerative colitis was 34.1% and 68.2%
        • Crohn disease was 30.0% and 60.0%
        • Irritable bowel syndrome was 46.7% and 73.3%
      • There was no significant difference between the three routes of FMT administration
  • The Taymount clinic uses a slightly different method of FMT wherein they filter out some aspects of the stool that may reduce any negative reactions like food and mucous cells.
  • It’s best to have multiple donors and undergo multiple FMTs

If you need help fixing your gut, click here.

Getting a New Gut Microbiota via Fecal Transplant with Glenn Taylor - RusioPodcast GTaylor
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Topics:
Episode Intro 00:00:42
What is FMT? … 00:01:17
Probiotics Do Not Colonize … 00:10:29
FMT, After All Other Therapies Exhausted … 00:11.59
How Effective is FMT? (Systematic Reviews) … 00:21:06
Glenn’s Method of FMT … 00:30:45
Different Technique for Different Conditions. … 00:35:27
Episode Wrap Up … 00:44:45

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Links:

How Effective is FMT? (Systematic Reviews)

  1. http://www.ncbi.nlm.nih.gov/pubmed/25223604 Trusted SourcePubMedGo to source
  2. https://www.ncbi.nlm.nih.gov/pubmed/28105618 Trusted SourcePubMedGo to source

Episode Wrap Up

  1. http://taymount.com/

Getting a New Gut Microbiota via Fecal Transplant with Glenn Taylor

Episode Intro

Dr. Michael Ruscio: Hi, everyone. Welcome to Dr. Ruscio Radio. This is Dr. Ruscio. I am here with Glenn Taylor from the Taymount Clinic that does FMT therapy, or fecal microbiota transplant therapy.

And we’ve been meaning to talk for a while. We’ve had a few scheduling snafus that have precluded that, but we’re finally connected today. And Glenn, happy to have you on the show. Excited to talk about FMT. Thanks for being here.

Glenn Taylor: Michael, thank you very much for inviting me. I hope we have a good time here.

DrMR: Well, I’m certainly looking forward to talking about this technique of FMT.

What is FMT?

And let’s first have you define, for people that haven’t heard of FMT—could you tell people a little bit about what FMT is and also how you got into offering FMT for people at the clinic that you operate out of in the UK?

GT: Okay. I shall do. My definition of fecal microbiota transplant is literally that. It’s transplanting whole microbiome from a donor into a recipient.

And the objective there is that we’re looking to increase diversity and density of the entire gut microbiome—the virome, the microbial content, bacteria—every component of it—fungi, protists—all of the living creatures that work symbiotically in the human gut.

And the reasoning behind it is to simply attempt to restore the numbers of expected, commensal, native species back to normal levels.

Now, how did I come across this? Well, I’ve been working with the human gut, trying to understand some work. My wife, Dr. Enid Taylor, was working on it. She is a naturopathic doctor who had been specializing in diet and food as an adjunct to treatments.

And part of that was looking at the way the gut behaved. And we were attempting to wash the gut and then use probiotics to see how we could change the construct of the microbiome. So we were carrying out a colon cleanse and supplementing heavily with multiple brands and types of probiotic.

And each time—it was most interesting—each time, the lab that we were using for the 16S RNA profiling—the DNA, if you want to call it, but it’s RNA—the profiling of the present micro flora.

They say, “Two weeks before you submit a sample, can you make sure that you actually stop all supplementation because that spoils the final issue of determining what bacteria are actually native as opposed to being supplemented?”

And like a fool, I simply said, “Yeah, no problem. We’ll stop supplementation.” And it was only after a couple of times of getting these phone calls saying, “Make sure you’ve stopped,” I asked the obvious question. “Why am I stopping?”

“Well, it’s so that we can eliminate the supplement.”

“Yeah, yeah, yeah. Why do I have to stop for you to eliminate? Why aren’t we getting engraftment? What’s happening to the supplementation? Why isn’t it there if you’re telling me you don’t want it to be there?”

And then it suddenly hit me that supplementation with probiotics clearly was not that successful. Of course, in the last couple of years, we’ve seen studies in the UK from King’s College and Imperial College London who have done independent laboratory studies on a number of different types of probiotic.

And they’ve determined that survivability through the stomach and being able to arrive in the gut successfully and then survive and thrive inside the colon is compromised with probiotics. I thought, “Crikey! They were absolutely right.”

So, where did I go? Well, all at the same time as we were trying to make sense of this, my wife had a very strange phone call. Dr. Enid took a call in another room. I wasn’t present at the time.

And a young man picked up the phone and said, “I’ve got a really, really unusual question to ask. I desperately don’t want you to put the phone down. Will you please, please just hear me out?” And Enid listened to him. He said, “I’m trying to find some way to do a fecal transplant.”

Well, she just flipped. All her training had been about no contamination, hygiene. And hearing this, she very quickly said, “I’m sorry. We don’t do that here. But I wish you good luck in finding what you’re looking for.”

She came through to me, all her feathers ruffled, and said, “You’d never guess the call I had.” And she explained it. And that was it. Bang! It hit me. Of course, if you’re looking for survivability, you’ve got to use species and bacteria that were familiar with the environment.

So I decided that I had to find a methodology of harvesting, storing, making sure they survived, and then reintroducing healthy bacteria from a tested sample and seeing if it was possible to rebuild the microbiota. And that was basically it.

We started with that. We looked for people who were completely clear of disease, had no pathogenicity, ones who were happy about that. Took a sample. Went through normal lab processes. Nothing that I do was new. It’s not patentable. It was simply good science.

And we went through a period of very carefully quarantining. Most, if not nearly all diseases, dispose themselves within three months of the patient actually acquiring the disease. So it was a matter of doing a safe collection, quarantine in the right environment. -84 suited us nicely. That’s centigrade. And continued to test the donor for any kind of abnormality both in blood and in the stool because we look for pathogenicity.

When we were satisfied all was okay, we tried an implant and found that by taking a sample post-implantation, we found a difference. We took a control sample of the patient’s stool and then took a sample after implant and found a major shift in the diversity and density of the micro flora. And I thought, “Right. Well, it works.”

We’re able to successfully achieve something called engraftment. Not colonization; that’s just bacteria growing. Engraftment is throwing out anchors and staying where they were put. And that methodology worked extremely well.

What surprised us was the number of conditions that it impinged upon. That was the big, big surprise. We thought it was something maybe we did for irritable bowel syndrome, simple formats like that. But the diseases that we’re coming across are quite widespread.

And it actually led us to believe that perhaps we should be looking at the gut and its friendly inhabitants, our micro flora, as a foundation of human health, that it’s where you start first. And if there is a severe disease that goes with it, a comorbidity, we should be perhaps dealing with the gut, restoring the micro flora, letting the body do what—

This is interesting. Doctors of functional medicine are in pretty much one accord that the human body does a remarkable job of healing itself if you give it all the right tools. I’ve heard that so many times. “All I want to do is get the patient to a certain point in their health and let the body get on with it.”

And to be honest, I think that healing the gut is one of the very first steps. Not healing; restoring the micro flora and allowing them to get on with it. Sorry, Michael, I’m talking too long.

DrMR: No, it’s a great lead in. You make a lot of great points, one of which I think the audience is fairly familiar with at this point, which is the importance of the gut and this start-with-the-gut philosophy. In my opinion, this is one of the key underpinnings of this cost-effective functional medicine model that I talk so much about.

And a lot of that really centers around doing a good job, first with the gut, and also with diet and lifestyle, which are really the first steps, but a lot of the diet and lifestyle also directly impact the gut.

But some of those fine points aside, the gut being one of the first areas that you intervene with and strive to heal clinically tends to make a lot of other testing and treatment obsolete, because the patient ends up seeing other symptoms and conditions improve themselves. So, absolutely on the same page with you on the fundamental importance and far-reaching effect of the gut.

Probiotics Do Not Colonize

And you make an interesting point about probiotics that we’ve talked about in the past also, which is that, yes, most probiotics don’t appear to colonize you.

But I think it is also important to mention that there is quite a bit of utility that has been documented for a number of conditions using probiotics. But it’s probably not because the probiotics colonize you.

But rather, the way I look at this is probiotics can give the microbiota a nudge. And sometimes, that nudge may be an anti-inflammatory nudge. It may be a nudge of actually being anti-bacterial, where probiotics have been shown to have anti-bacterial effects. But for people that just need a nudge to recalibrate or rebalance the microbiota, probiotics tend to be effective.

Now, there are certainly cases where probiotics are not enough and we have to do other things like aggressive anti-microbial therapy or special liquid diets or elimination diets. And even at the end of the line when everything else hasn’t worked properly, then we may need to attempt to totally re-configure or transplant the microbiota. And this is where FMT comes in.

So certainly, there are a lot of options for the patient out there. It’s just trying to get the right person to the right treatment. And we’ve talked about this before. And I’m assuming that you agree with this, Glenn. But if not, please let me know.

FMT, After All Other Therapies Exhausted

But it seems that most of the people we’ve had conversations with regarding FMT don’t recommend it as a frontline therapy. Of course, it’s a little bit invasive for a frontline therapy. But if people have exhausted the other alternatives for improving their gut health, then this seems to make a lot of sense.

And I would certainly put this before some of the other therapies that are used in functional medicine because of the gut-first philosophy.

So, if we’re going to start with the gut, we would, again, in my opinion—Glenn, if you have a disagreement with this, please let me know—but we would start with the gut, and the preliminary therapies would be the least invasive—things like diet and probiotics.

And then once we’ve exhausted all the preliminary therapies and other available therapies for the gut and someone is still not getting the optimum response, then FMT tends to be a great alternative.

GT: Okay. Yeah, I agree with a lot of what you’re saying there, because part of the program when people come to us to have your gut microbiota is that we have to make sure they understand that their environment is absolutely critical to their bacteria.

DrMR: Right.

GT: Let’s make sure everybody understands here. Bacteria are fussier eaters than teenagers. They like their substrate. They’re quite specific about what their enzymes that they produce can actually break down. So they live in an ordered structure.

They have an order in which bacteria, who make hundreds of times more enzymes than we humans can, when substrate food—what we’ve eaten—when substrate allies with them, species take it in turn to crack and break the molecule in the nutritional food substance down as they work their way through.

So a species will leap, and at the top, they’ll start. Other species will come in and say, “Hey, that’s stuff I can use.” They’ll break that. More species, and the whole thing cascades down.

And to make sure the entire food chain is fed, there’s such a structure that goes with it, which, I’ll just jump in here quickly and say. So when you apply a treatment like an antibiotic, when that is used—

And of course, the antibiotics kill bacteria by particular methodologies. And they kill the pathogenic (which their target species are) and similar styles of commensal. They’re killed by exactly the same mechanism.

So you’ve gone in to kill a pathogen. But at the same time, you’ve killed one of your native, commensal species. Now, if each one of those at a critical point in this digestive cascade as it goes from top to bottom is not there to break the food down further, who feeds the little guys below?

This is why antibiotics are not just having an immediate effect upon the species that they kill, but because it’s a whole micro environment, it has an effect on all the other species that are dependent upon that species being present. Does that make sense?

DrMR: Yes. Yeah, I completely agree.

GT: I bet.

DrMR: And speaking more broadly, one of the common threads that I write throughout the book that I’m hoping to get out there sooner rather than later, but it’s like the task that I can never finish.

But one of the key concepts that’s thread throughout the book is you have to create a healthy environment for your bacteria. And there are numerous examples of this—stress, sleep. Even those with type 1 diabetes when they start insulin therapy, we see a great normalization of their microbiota because the environment that you create for the microbiota has such a profound impact.

And it goes beyond, as you’re saying, Glenn, of course, diet. But it even goes beyond that. Sleep and stress and exercise—all these things have been shown to have an impact on the environment that you create in your body. And, therefore, what kind of bacteria will the environment then be hospitable for? So completely agreed with you there.

GT: And I’m totally, totally with you on that one. The treatment package when you have your gut microbiota must include, first of all, understanding your own environment and make sure that you’re eating the right foods. At least you’ve got substrate anyway.

But as you so accurately said, hormones play havoc with your gut bacteria if they start to respond in different strengths. So gut bacteria are affected by somebody’s emotional state, as you say, stress. Everything within in our environment remodels our gut micro flora. It’s very, very sensitive indeed.

And so, yes, it’s not just the last meal you had but the last row you had. And so we have to sit with patients and make sure they totally understand all of the ramifications of lifestyle. And that is every element of it.

And you said at one point, it may not necessarily be the treatment of first choice. Now, yeah, I’m with you on that one. Things you can do first of all are look at the patient’s lifestyle. Look at their stress levels. Look at their sleep levels. Look at their food. Look at everything within their immediate environment to improve that.

You also said that it may not necessary be seen, particularly by physicians, as a treatment of first choice. But I’m going to jump in and tell you something here.

We’ve got a very notable gastroenterologist who works at one of the top hospitals in London who contacted me and said, “Can you take my patient please? Every time I sit with him, there’s this huge white noise of symptoms. They just sit and say, ‘Oh, and I’ve got this. And then I’ve got that. And this aches and that.’”

And he said, “I’m completely confused. I cannot make sense of all the symptoms because there are too many. But I’ve identified enough to see that a dysbiotic gut by whatever—by pathogenicity, by overuse of antibiotics, whatever it is—I can identify that the gut is not right because they’ve told me enough. How about you fix the gut and give them back?”

So we did. Patient went through our program, having the gut micro flora changed. Handed him back to the gastroenterologist, who then contacted me a few weeks later and said, “That did it. See, when they came back in and I asked about all those previous symptoms, a large number had gone. And that large number was actually a conflict for me to really understand and be incisive about the symptoms I saw.

“This time, I saw exactly what the problem was. And we came up with a resolution. So we shut the white noise in the patient by getting rid of so many of those non-stop symptoms that keep occurring every time the patient’s gut falls out of balance.”

So I’ll tell you, whilst we don’t see patients here until every single drug has failed and every single physician who has treated the patient has drawn a blank and just said, “I don’t know what to do. I don’t understand the etiology in the first instance. And I haven’t got a treatment program to offer you. And maybe I’ll put you on anti-depressants.”

So those patients arrive to us. They always arrive too late after having undergone too many other methodologies of treatment. So yeah, we’ve got an uphill struggle. But we just then put in the gut bacteria, normalize, and then step back and wait.

DrMR: Yeah, I think you make a good point there. And maybe I can add a little bit to my previous comment or clarify, because when I say someone has exhausted the available gut therapies, there are a few nuances there that I think are worth mentioning.

If it’s a case of inflammatory bowel disease, I would probably have them elect to undergo FMT before being on Humira for an extended period of time. So there are a few things there. And of course, way before any kind of surgical intervention. So there are a few nuances there.

I should maybe say “after someone has exhausted all the minimally invasive and mostly natural therapies for the gut.” Of course, before someone undergoes extensive antibiotic therapy or some of these immunosuppressive drugs that have pretty noteworthy side effects, I would definitely place the FMT way before those.

How Effective is FMT? (Systematic Reviews)

And we’re talking about some conditions that this works for. So I wanted to chime in with a little bit of research that has surfaced recently that showcases some conditions and what patients can expect for a response rate for a given condition.

And then I’d like to get your take, Glenn, in terms of rough approximations, in terms of different conditions that you’re seeing and what you see the success rate as being, because I think that’s something else that’s important for people. Sometimes, they may build up FMT as this miracle treatment, which it can be, but they don’t go into the therapy with a reasonable expectation.

So let me give some of these research findings. And then I’d love for you to enhance upon that with what you’ve seen in terms of a rough response rate for different symptoms or conditions, inflammatory bowel disease probably being one of the most notable. And I think this is probably the next condition that we’ll get FDA approval here in the States.

There was a systematic review Trusted SourcePubMedGo to source (1a) with meta-analysis that showed the effectiveness for IBD ranges anywhere from 20% to 60%, with an overall effectiveness of about 45% for inducing remission. So I think that’s actually pretty darn good.

If half the cases will go into remission, especially when we’re looking at those patients potentially being put on a pretty powerful and side-effect-ridden immunosuppressive drug or even having surgery, I think that’s pretty excellent.

GT: Absolutely. Compared to resolutions by pharmacology, yes.

DrMR: Right. Right. Now, there was another paper Trusted SourcePubMedGo to source (2a) that was published just recently, 406 cases in a Chinese center. And they did a nice breakdown here for recurring Clostridium difficile infection. And they break this down, cure rate and improvement rate. So the cure rate was 85%, improvement rate 95%. No news there.

I think everyone knows that for recurrent C. diff it’s an excellent therapy. For constipation, they saw a cure rate—and I should mention, this is in 406 cases so it’s a decent sample size.

Constipation—40% cure rate, 67% response rate or improvement rate. Ulcerative colitis—34% cure rate, 68% improvement rate. That falls in with the previous study we mentioned. Crohn’s disease—30% cure rate, 60% improvement rate.

And this one I thought was the most interesting, and probably what a lot of people are wondering about. IBS—46% cure rate, 73% improvement rate.

So that was pretty interesting. And they didn’t find a significant difference in effectiveness between the three routes of administration, which were nasointestinal tube, FMT capsules, or colonoscopy administration.

So they showed that there was definitely some noteworthiness in terms of effect. And the route of administration didn’t seem to make a big difference.

So that’s what I wanted to throw into the mix, Glenn. What would you offer in terms of conditions this works well for and maybe some that you haven’t seen them work well for?

GT: Okay. Well, based on the numbers that we’ve carried—now, in terms of actual procedures, we’re something like 20,000 procedures now, which probably makes us more than anybody else in the world. I would say that we broadly reflect those figures that you’ve given.

In general terms of thirds, we see fairly rapid resolution in IBD. A third resolve fairly quickly. We see another third resolving or getting some partial resolution or even sufficient resolution for the patient to be quite happy with over the next third.

And then we get a resistance in the final third. That’s the really interesting one. That’s the one that St. Thomas’ Hospital in London is looking at very carefully, the immunology department, to try to work out what the genetic expression is that we’re unable to switch on or off that’s stopping the patient who has the same disease as another patient, who receives exactly the same implants as another patient, but responds completely differently.

And that is coming down to the way that our expressions are currently working out, genetic expression.

So that’s one of the reasons why we have to explain to patients. There’s an expectation out there, as you’ve so correctly said, that this is the 21st century panacea to all ills. It is not!

It has as good as, if not better resolutions than pharmacology with an awful lot less side effects. The application can be quite important. The only documented, directly attributed death by FMT was by a nasogastric tube where the patient vomited and aspirated whole feces into their lungs and succumbed to a bacterial pneumonia.

Now, that relegates that particular methodology to exceptionally high risk. And some of you may have read the Yale Med report of the number of patients who are received back in the ER post colonoscopy for simple scanning for disease rather than a disease. So disease patients were eliminated from the study.

And it was 1.7, I believe, within seven days were readmitted to an ER with a complication following colonoscopy. But in 30 days, 3.8% of all patients had some form of a complication.

Now, 20,000 with a pediatric retro catheter. And we’ve yet to have a major complication that requires a patient to be readmitted to a hospital. So our methodology, I think, is least invasive. So I know you talked earlier about invasive procedure. But no question, it’s the least invasive, best tolerated.

Of course, it requires no sedation, minimal cost, colonoscopy is $1000 a time. So this allows us to revisit the patient who can tolerate the treatment on a much more frequent basis.

Now, Clostridium difficile, our methodology is five implants on five different days from five different donors, each donor having a completely different profile. Why? Because it’s quite clear that the more diverse and dense your gut micro flora is, the less likely a patient is to succumb to Clostridium difficile infection. It’s a simple fact.

Diversity and density correlate completely to Clostridium difficile infection. So when a doctor goes in and puts one implant in and gets a 75% improvement and says, “Wow! That was good,” I said, “Do it again.” And you get to 80. And they go, “This is fantastic!” Well, do it again. “Well, do you really—No, 80 is pretty good.” No, do it again—85, 90, 95.

We have a 100% record with Clostridium difficile because we implant five times rectally without the patient having any major problems with that.

And we’ve published on this. And for the life of us, we cannot understand why others aren’t doing the same thing. If we get 100%, isn’t that an indication that perhaps the other methodologies could be improved upon?

One thing—the Chinese study didn’t go into great detail about how they harvest it. They just talked about a whole stool. And a lot of them, of course, talk about fresh. And I already covered that one. Even asymptomatic donors may be carrying something grossly pathogenic. You just don’t want to be in that place, do you? Hep B, Hep C.

“Well, my donor is fine. I know their lifestyle. They live with me. They’re well behaved. They don’t go to the wrong type of bars at night. I know my donor is fine.” Really? Do you really want to put that to the test? Why not? Frozen works very well.

Khoruts did a study on fresh against frozen and found that frozen was every bit as good as fresh but safer. Where is he out of? He’s out of Minneapolis, isn’t he? But that particular study showed that if you really want to be safe—and that’s something the Chinese didn’t particularly cover—then frozen implants are perhaps the best defense.

Glenn’s Method of FMT

DrMR: This may be a good transition to your method, because your method is a little different than standard FMT. Do you want to expand a little bit upon that now?

GT: Well, yeah. Although, that said and done. And some studies that have come out in the last couple of days about the—what should we call it? Supernatant fluid, the liquor. There’s a liquid element that appears to be working with Clostridium difficile infection. And that we can unravel and talk about.

But our methodology was the patient often arrives at the clinic having undergone some kind of porosity issues and is having some fairly substantial immunology problems. They are having a resistance to specific food groups. They’ve reduced the amount of foods they can possibly take on their diet to reduce the inflammation.

So the chance is that the donor may, on that particular day, have eaten something that the recipient may not respond favorably to. In implant, we have to eliminate whole foods. So stool comes in under anaerobic conditions with oxygen, obviously. We use nitrogen to displace atmospheric air.

We put it through a filtering system. There’s a British company that make a fantastic, sealed filtering system where we can introduce the nitrogen and stop the oxygen damaging the obligate anaerobes. Then we remove the solid food particles and end up with a slurry.

The slurry we separate out because, of course, the slurry contains the donor’s mucus. It contains the donor’s epithelial skin cells. It contains some parts of their hormone, their endocrine system, most of which is excreted through urine, but also comes out through the gut. The liver is throwing toxins left, right, and center out through the alimentary tract. So it’s a pretty interesting soup, if you want to call it, as well as the micro flora, the whole group of other chemicals that are also being disposed out through the waste system.

So our method was to separate out the solids from the solutes. And we do so in a refrigerated, specially made centrifuge, which means that we’re left with a pellet. The pellet contains some very small particles remaining from the food and the micro flora. That is then stored with a small amount of a cryoprotectant liquid so that we can put them into vials. And basically, it’s the living content of whole stool and the remainder being disposed of. So obviously, that’s much easier to store. And then, putting it back in the human gut—

DrMR: Glenn, the bacteria, the fungus, viruses, and protozoa—are those all still intact? Or are those altered slightly because of the filtration process that you go through?

GT: Okay. Now, some people can make mistakes here by trying to centrifuge at too high a rate. Anything above 1700 times gravity, 1700 G, is going to do significant damage to the caps or the structure of the micro flora. So you keep it safely below. And you don’t allow hot spots by compression to establish. And you will retain intact bacteria. After all, what does any student on a microbiology course do in his first semester? Learn how to separate out his sample via centrifuge and learns when the mistakes are made. “Oh, I spun it up too fast. And look, they’ve all gone [spits]. And I can’t read them now under the microscope because I’ve destroyed them.”

So you wind back. And you make sure you keep all your micro flora alive. They’re robust. And because they’re so very small, they can be able to tolerate quite large amounts of stress that are exhibited in the centrifuge. So we do manage it. These are micro flora that we can spin up, freeze, take out, restore, get them under a microscope, and see them swimming furiously away

Different Technique for Different Conditions

DrMR: Gotcha. Gotcha. Now, we’ve talked about the technique for Clostridium difficile. And I’m assuming you have a slightly different technique if someone has IBS or IBD.

I believe for C. diff., three to five enemas. Oftentimes, I’ve heard the recommendation of, for IBS or IBD, ten. Ten treatments may be what’s required. Do you have a different technique for IBD compared to IBS compared to C. diff. or other conditions?

GT: Yeah, well, that ten may well be my idea, first of all.

DrMR: Oh, good to know.

GT: I’ve been doing this for five years. And what I needed to do was be able to provide a broad enough micro flora. And to do so, I opted not to use single donors. I have to get a big stable together. And so for me, it was finding lots and lots of different people.

Our donors are great. No one is perfect. You don’t find a super donor anywhere. There are those that are brilliant, but still they don’t have everything. That’s because everyone lives a different lifestyle. Everybody’s lifestyle, everything that they do in their life, models their gut micro flora.

So some people have a particular occupation, have a particular penchant for certain foods. They have outdoors, indoors. They have children. They have pets. There’s any number of environmental differences that decide what type of gut micro flora they have.

Now, based on that, our donors are fantastic. Not only are they free of disease, but they are particularly good in certain areas. So the analogy I draw—and let’s hope Stan Lee doesn’t jump up and down on me on this one. My apologies to Marvel Comics—is that we have donors like—we’ve got one guy who’s great at one thing. And he’s Iron Man. And we’ve got another one who’s the Hulk. And we’ve got Captain America.

But when we put them all together, we get the Avengers in terms of diversity. Now, I was talking to Jeff Leach. Jeff is an anthropologist who works out in Africa and was involved in the American Gut Project with Rob Knight. And he’s an old friend.

And we were chewing the fat over diversity. This then ended up in one of his recent books. He said that this current generation of human beings, because of poor food choices and over hygienic environment and pathogenicity in our environment, has the worst diversity and density of gut bacteria of any generation in the entire history of our species. Shocking! And any attempt to try to restore it from our own number has got to be a fool’s errand.

So I said, “Jeff, what I do is I have a whole stable of donors.”

And he went, “Now, that’s clever.”

And really, it’s not particularly clever. It’s just that you have a number of different people.

So our methodology of the treatment is that we want to expose the patient to a minimum of ten different implant types from different donors which, because of travel expense, etc., and the fact that I established this to be a little tiny—and I mean tiny—clinic in England treating English patients who have gut diseases.

But somebody blabbed on the internet. It went absolutely wild. My phone melted. We had to open a bigger clinic. And people fly in literally from the entire globe to get to us. Now, when we do that, there’s an obligation to help these people achieve a resolution of some sort in a given time period in a given budget.

So we attempt to try to put the micro flora in place—five days give them a break over the weekend, another five days. So we get ten implants. Plus, they get to take some home. We give them some implants to take home. And in some instances, they say, “Can I please have some more?” And we provide those for them as well as an add-on to the cost. And they continue.

Sometimes for a long period of afterwards, we get a phone call or an email saying, “Can you send me another couple?” And we have them now made up as entire kits in sterile packaging, particularly cryo packs to keep them frozen. And we send them around the world so they can get to people, so if they’re on a long term process of getting through their particular condition, we’re able to provide them.

But ten in ten days is a compromise. It is quite intense. And some people struggle with that level of intensity. And maybe in those instances, it would be better if we could invite them to come and stay in England for three months and stay at a hotel accommodation and stop their job and their income for three months. You can’t do that. So it has to be some form of a compromise.

Ideally, I would like people to be able to come in on a greater periodicity of maybe once a week, once every two weeks and have another implant, settle down, let the immune system get over the shock of having bacteria either it has never met before or it hasn’t seen for a very long time, because the immune system responds.

Bacteria—let’s not forget this—are pro-inflammatory in their action. So when they turn up in an area where there’s current inflammation, we are throwing a bucket of gasoline on a fire.

That’s why you never, ever do FMT during an IBD flare. Whatever it takes to bring the flare under control, whatever anti-inflammatory you can do, bring it under control. Don’t think about it anymore. Leave it for later.

So we want patients to be on a much more measured, slower treatment program. But economics of employment and all the other things thrown into the mix make that very difficult for patients who have to travel a great distance. For that reason, we’re currently in a program of, if the mountain won’t come, we’re going to have to go to the mountain.

DrMR: Sure.

GT: So we’ve got a program of quite a few clinics over the world who are expressing an interest in becoming a Taymount Clinic and getting the Taymount protocols. And as you already discussed, we have the Bahamas Medical Center that carries out the Taymount protocols.

We’re in discussion with a so-far unnamed Canadian group so that we can provide in Vancouver, Toronto, and Montreal. We have a partnership clinic in Germany. We are going over to Paris in a couple of weeks. Next week, we will be in the Czech Republic and Slovakia to answer questions there. We’re going down to Greece. We’re going over to the little Mediterranean holiday island of Cyprus. We’ve been asked whether we can talk to a hospital group in Dubai, Singapore. And we have been in discussions with Hong Kong. That got a little bit tricky.

So we’re looking at bringing what we do into a different area, into people’s neighborhood, so that they are able to spend maybe a longer time on a program, do it in a more relaxed fashion so we can study the differences of treating an intensive ten-day and perhaps stretching this treatment program out over weeks, possibly even months.

We know the methodology we have now is not perfect. And we will never, ever say that what we’re doing now is the answer. We’re always looking to improve.

DrMR: Well, I hope you make some inroads with the United States at some point, because I would love for people in the US to have greater access to this and not to have to do this under the radar, underground, or using a consultant to try to spackle together a way to do this, do-it-yourself at home.

I think—and I’m hoping—that that will change soon. But sometimes, we’re slow to move. But in agreement with you that I’d love to see this become more widespread. It sounds like you’re doing an amazing job of working to that endpoint.

Episode Wrap Up

Glenn, we’re coming up on time. Are there any final thoughts that you’d like to leave the audience with? And then, please do tell people about where they can contact you or your clinic if they wanted to get more information.

GT: Okay. It sounds like one huge advertisement or commercial. But if you want to learn a little bit more, you can go to my clinic website. And that’s Taymount.com. For those who keep asking the question, “Well, what is ‘Taymount’? Why?” It’s Glenn Taylor and Dr. Enid Learmount. Put it together. It’s a bit twee [tacky]. I do apologize for that. But that’s the origin of it.

I know because you have a somewhat unique commercial administrative set of circumstances in the United States that FMT is a challenge for you. Good luck in sorting that one out. I’m not sure where the answer lies.

But that on its own prompts people to take things into their own hands. And because they poop every day, they think that they’re going to be able to do something. I watch a lot of TV programs on medical subjects. And I’ve seen brain surgery and heart surgery. I’m not going to try it.

DrMR: Well said.

GT: If you do feel that everything is going against you and it is the only thing you can try yourself at home, look, donors within your own family group are likely to share exactly what you’ve got now. You need strangers. And if you’re going to go to strangers, you need to be safe.

So whatever methodology has got to be complete. You have to know your donor over a long period of time and be prepared to test them over a long period of time to make sure that they are not harboring something that’s going to go boom! just when you don’t want it to.

So take care with your donors. Don’t necessarily go for family members, because they may not have the diversity that you might be looking for. The methodology of implant—well, we have a patent that comes out. What’s the day today? What are we looking at? Oh, my Lord. It comes out—

DrMR: March 7th.

GT: Okay, tomorrow our patent is published. And I cannot talk about it today or I really will be told off. But we have a patent about a new method being able to ensure survivability over a broad range of temperatures and other conditions, time being one of them.

So this new method of finding a medium in which to hold the bacteria inactive and deliver them exactly where we need to will be available to look at tomorrow.

DrMR: Good. Congratulations also!

GT: Very much. Sure. Look, take care of yourselves. Don’t do anything really foolish and rash. Seek the best information you can from the best source. Listen to science. Don’t try to make things up as you go along.

Where else can I take this? People are going to want to try to do FMT at home in the privacy of their own bathrooms. I understand why you do. Just take care of yourself when you do.

DrMR: I think those are all great points. And Glenn, thank you so much for the contributions you’ve made to this field. I wasn’t aware of how many clinics you’re in process of setting up. And I think that’s just terrific, because it’ll make this more accessible to the growing number of people that need to repair their gut health and need this therapy to do that.

So thank you for everything that you’re doing for the field. And thank you again for taking the time to talk with us. And how close are you to King’s College where you’re located?

GT: King’s, 25 minutes into central London from exactly where we’re located. And then it depends on which campus you’re looking at. It is a widespread campus in various parts of London. We can get to some parts of that campus in another ten minutes. They’re in central and south London.

DrMR: Oh, great.

GT: So it depends on specifically what you’re looking for.

DrMR: I’m not sure exactly where it was on King’s College, but I spoke there in January of last year. And we might be setting up another lecture late this year. So if I’m out that way, I’ll let you know. And maybe we can connect while I’m out there.

GT: Okay. Was it with something that Chris Kresser put on last year?

DrMR: Yeah, it was at the same venue. Chris Kresser went through there. Mark Hyman went through there. Kelly Brogan went through there. So there have been a number of people. It’s through Refined Health that has an outfit in London that does education.

So they’ve been asking me to come back. And we might be able to make the scheduling work for October of this year. So I will keep you posted. And maybe we can meet face to face if I’m out your way.

GT: Excellent. A number of those names you just mentioned have visited the Taymount Clinic to talk about things. So yeah, we would really welcome you.

DrMR: Great! Well, Glenn. Thanks again. And hopefully, I’ll meet you later this year.

GT: Looking forward to it.

DrMR: Thanks, Glenn.

GT: Thank you for having me.


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What do you think? I would like to hear your thoughts or experience with this.

Dr. Ruscio is your leading functional and integrative doctor specializing in gut related disorders such as SIBO, leaky gut, Celiac, IBS and in thyroid disorders such as hypothyroid and hyperthyroid. For more information on how to become a patient, please contact our office. Serving the San Francisco bay area and distance patients via phone and Skype.

Discussion

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26 thoughts on “Getting a New Gut Microbiota via Fecal Transplant with Glenn Taylor

  1. Great interview and very interesting that you would recommend FMT above Humira.

    Question: If a patient received too many antibiotics in her first year, would FMT still graft successfully? Or is it only for people who had diversity as a baby but lost it later in life due to an infection, etc? Just wondering if the patient’s immune system would reject the unfamiliar bacteria so FMT wouldn’t work for them…

    1. Hi Gd,
      In my opinion this really has to be taken on a case by case basis because there is so much we do not know yet. In terms of predicting who it would work for I would think of it by condition and not by history because that is where we have the best data.
      Hope this helps.

  2. Great interview and very interesting that you would recommend FMT above Humira.

    Question: If a patient received too many antibiotics in her first year, would FMT still graft successfully? Or is it only for people who had diversity as a baby but lost it later in life due to an infection, etc? Just wondering if the patient’s immune system would reject the unfamiliar bacteria so FMT wouldn’t work for them…

    1. Hi Gd,
      In my opinion this really has to be taken on a case by case basis because there is so much we do not know yet. In terms of predicting who it would work for I would think of it by condition and not by history because that is where we have the best data.
      Hope this helps.

  3. Love Dr. Ruscio’s reports and revelations. He is always logical and incisive in his analyses.
    This guy is a bit wordy and hard to understand, though still informative. I would suggest that the
    person in the background blowing his nose, counting coins or whatever, be more silent. Might help
    the clarity of the English accent.

  4. Love Dr. Ruscio’s reports and revelations. He is always logical and incisive in his analyses.
    This guy is a bit wordy and hard to understand, though still informative. I would suggest that the
    person in the background blowing his nose, counting coins or whatever, be more silent. Might help
    the clarity of the English accent.

  5. I am all for FMT, personally I suffer from severe gut problems and I am booked in at CDD here in a Sydney for an implant which is costing me over Australia $8000. Dr Taylor does not shy away from the fact that he is opening numerous clinics and after checking his website his fees are similar. My personal feelings are these people are taking advantage of this procedure. If they really put the health of their clients ahead of the need to make more money, they would lower the cost thus making this procedure available to lot more sufferers.

  6. I am all for FMT, personally I suffer from severe gut problems and I am booked in at CDD here in a Sydney for an implant which is costing me over Australia $8000. Dr Taylor does not shy away from the fact that he is opening numerous clinics and after checking his website his fees are similar. My personal feelings are these people are taking advantage of this procedure. If they really put the health of their clients ahead of the need to make more money, they would lower the cost thus making this procedure available to lot more sufferers.

  7. I am always amazing that doctor Taylor almost always seems to avoid speaking about IBS when talking about success rates. This concerns me, because if it was very successful, he would be touting it. I know IBS could have many different causes, but it seems like the indication that would make the most sense to be successful based on other studies and many reasons people seem to acquire the problem.

      1. Yes, I have come across people who have had huge success with DIY. It seems many benefit to some degree at the beginning, but it doesn’t always last long term.

  8. I am always amazing that doctor Taylor almost always seems to avoid speaking about IBS when talking about success rates. This concerns me, because if it was very successful, he would be touting it. I know IBS could have many different causes, but it seems like the indication that would make the most sense to be successful based on other studies and many reasons people seem to acquire the problem.

      1. Yes, I have come across people who have had huge success with DIY. It seems many benefit to some degree at the beginning, but it doesn’t always last long term.

  9. Hi Dr Ruscio

    On a previous podcast one of your colleagues gave her testimony regards her treatment at the Taymount clinic. I understand she had a history of IBS symptoms. It would be interesting to know how she is doing now,Did the FMT make a big difference for her?

    Best wishes

    Mark

  10. Hi Dr Ruscio

    On a previous podcast one of your colleagues gave her testimony regards her treatment at the Taymount clinic. I understand she had a history of IBS symptoms. It would be interesting to know how she is doing now,Did the FMT make a big difference for her?

    Best wishes

    Mark

  11. Dr Ruscio,

    Do you believe the stool from UK donors would significantly increase a person’s risk of developing vCJD given the exposure to the UK population in the 80s and 90s?

    There is one study (http://www.cidrap.umn.edu/news-perspective/2013/10/study-uk-1-2000-may-carry-vcjd-protein) that shows one out of 2000 people in UK may carry the abnormal proteins associated with vCJD, but one would think the incidence of vCJD would be much higher if this were true.

    I am very interested in hearing your thoughts on this possible risk of FMT utilizing stool samples from the UK.

    Thank you for your many interesting and helpful posts.
    Jon

  12. Dr Ruscio,

    Do you believe the stool from UK donors would significantly increase a person’s risk of developing vCJD given the exposure to the UK population in the 80s and 90s?

    There is one study (http://www.cidrap.umn.edu/news-perspective/2013/10/study-uk-1-2000-may-carry-vcjd-protein) that shows one out of 2000 people in UK may carry the abnormal proteins associated with vCJD, but one would think the incidence of vCJD would be much higher if this were true.

    I am very interested in hearing your thoughts on this possible risk of FMT utilizing stool samples from the UK.

    Thank you for your many interesting and helpful posts.
    Jon

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