Since it looks like fecal microbiome transplantation (FMT) is not currently available to the masses, unless you you have C.diff, severe IBS, live in China or are able to find a trial and qualify for it. I have been wondering whether we have anything else at our disposal that might be able to offer a significant portion of the health benefits of FMT? FMT is known to positively alter the gut microbiome away from pathogenic bacteria toward health promoting bacteria, resulting in improved health and significant reduction of multiple health issues and in some cases it may actually act as a cure.
I think current research confirms many of the health benefits of FMT and I previously wrote about many of these benefits here :
healthunlocked.com/cure-par...
FMT works by transplanting a portion of the healthy gut microbiome from a very healthy donor into a person with a specific health issue to try and improve the health issue of the recipient.
One way to try and emulate the effects of FMT on the gut microbiome is through the use of probiotics, but in general, probiotics are too underpowered to obtain the same effects as FMT. Many manufacturers try to improve the effects of their probiotics by including prebiotics in their probiotics to form synbiotics with the intention being that the prebiotic will feed the probiotic bacteria as well as feed the healthful bacteria in the gut to attempt to increase the dominance of healthful bacteria in the gut and consequently reducing pathogenic bacteria. Synbiotics are a good idea, but apparently insufficient to grow the healthful bacteria into dominance in the gut microbiome.
When you consider that these synbiotic capsules are often delivered in a capsule that is generally of a size that can deliver 500 mg or less of a supplement, you start to realize why these synbiotics are underpowered for the task at hand. Afterall, FMT is usually delivered in a significantly larger dose than these synbiotics which contain both the probiotic and prebiotic in such a small capsule.
This brings me to a new study (April, 2024) that used a combination of 6 probiotics and prebiotic (Inulin) in combination, but the prebiotic alone consisted of 5 grams (5000 mg) of Inulin prebiotic. Compare this to the size of synbiotic capsules that are sized to deliver 500 mg or less of both probiotic and prebiotic combined in one capsule. The 5 grams of inulin alone is 5 times or more than the combined total prebiotic and probiotic in the synbiotic capsule and likely at least 10 times the amount of prebiotic found in the capsule. Here is a link to the trial (RCT) that showed that using this larger amount of inulin with a fairly high dose of colony forming units (CFUs) of 30 billion CFUs of probiotic bacteria had a significant health impact on the participants that received it, in terms of significantly increasing health promoting short chain fatty acids (SCFAs) and anti inflammatory IL-10 over 12 weeks :
sciencedirect.com/science/a...
Here is a relevant quote from the RCT :
' There were no significant differences between the baseline characteristics of patients in the two groups. Serum IL-10 was increased in the synbiotic group (p < 0.0001). Moreover, synbiotic supplementation increased fecal concentration of acetate (p < 0.0001), butyrate (p = 0.043), propionate (p < 0.0001), and valerate (p < 0.026). A significant positive correlation was observed between the changes in fecal butyrate level and serum IL-10 concentration in the control group (r = 0.48, p = 0.01).'
It is worth reiterating that the p value of the increase of anti inflammatory IL-10 was less than 0.0001, a significant improvement and the increase in SCFAs was also significant. It is also worth mentioning that studies have shown that FMT also significantly increase SCFAs. The following study adds confirmation to the idea that FMT increases SCFAs :
Here is a relevant study quote :
' In addition, there was a significant increase in combined SCFA levels at 12 months post-transplant within the rCDI group compared to that of their pre-transplant levels, and, more specifically, acetate, propionate, and isovalerate increased from pre-transplant to 12 months post-transplant. The longitudinal aspect of this study allowed us to identify mechanisms that contribute to the durability of responses to FMT, as well as characterize the unique patterns of short-chain fatty acid level recovery in rCDI pediatric patients.'
For comparison, the synbiotic I take, contains 300 mg of a prebiotic blend in total. This means that the study dose of prebiotic used is almost 17 times what is contained in my synbiotic, a very significant difference. My synbiotic also contains 300 billion CFUs of 24 probiotic bacteria or about 10 times the CFUs used in the study and 4 times the strains used in the study, if my label is accurate. Currently I see Synbiotics that contain 900 CFUs of probiotic bacteria in two capsules which is 450 CFUs per capsule or 50% more bacteria than I am currently taking in one capsule.
Based on this RCT and its results, the observed benefits would clearly be beneficial in many health issues and especially in health issues which have a significant inflammatory component.
Unfortunately, this study limited the criteria to just these five parameters, but in my opinion, I feel certain that had they expanded the criteria significantly, the results would have revealed significantly more potential for even more health benefits, especially had the study been longer than 12 weeks. They didn't test any markers for oxidative stress, but significantly increasing SCFAs as they did in this study, has reduced oxidative stress in other studies as well as improved the lipid profile. I have mentioned it on the forum before, but in case you missed it, increased SCFAs in the gut, naturally increase gut melatonin and melatonin receptor levels without side effects and melatonin in turn can further increase SCFAs, which is a nice cycle to have going in the dysbiotic gut that PwP are often noted for having. Natural ways of achieving higher melatonin levels are good for the gut microbiome, good for us and good for our health as whole. Did I mention that melatonin is good for PwP?
I have been testing my 300 billion CFUs (from 24 different bacterial strains) synbiotic that also contains 300 mg of prebiotic blend for almost a year which was successful in terms of eliminating bloating. One month ago I added 10 grams of Inulin prebiotic or double the dose used in the above study and because I have psoriasis, I can see changes fairly quickly in the appearance of my skin and in this case, even though just at one month in to testing, I can see noticeable improvement that appears to be continuing and improving so far which I did not see with the probiotic alone. A downside to inulin at the higher dose of 10 grams/day that I am taking is that it causes gas similarly to other prebiotic fibers at such high dose, such as resistant potato starch, but the gas effect has diminished a bit over the month I have been taking it. On the other hand, the 5 grams of inulin used in the study gave me little to no gas.
For now, this may be as close as we can get to the effects of FMT in two supplements that are available to pretty much everyone. In one PD/FMT trial, one participant mentioned that his psoriasis that was refractory to the highly potent topical steroid, Clobetasol, cleared during the trial after receiving FMT in the 12 week trial. In any case, this seems like it may be worth testing to see if it can benefit your health over a 12 week trial for those who are interested. Here are links to the two products I am currently testing. I am not recommending these, just showing what I am currently testing and I will mention that this is not the probiotic used in the PD/Probiotic study that I linked to further down in this post. That study probiotic called HEXBIO, ameliorated constipation and significantly improved MDS UPDRS ll (daily activities) and lll (motor function) scoring :
Inulin
amazon.com/Jerusalem-Artich...
300 Billion CFU Probiotic
amazon.com/Probiotics-probi...
In this September, 2022 review discussing the benefits of increased SCFAs, they show multiple health benefits associated with such increase :
Here is a relevant quote from the review :
' SCFAs show various bioactivities, such as anti-inflammatory and immunoregulatory effects, as well as preventive and therapeutic effects on several diseases, including obesity, cardiovascular disease, liver disease, diabetes mellitus, IBDs, diarrhea, constipation, neurodegenerative diseases, neuropsychiatric diseases, cancers, arthritis and periodontal disease, and so on. '
When you look at the above quote from the review, you can start to see many similarities between the effects of increased SCFAs compared to FMT. Add in the anti inflammatory effects from the increased levels of IL-10 and you can see even further similarities to FMT. I think the results of FMT would be much faster than this alternative method because FMT already has the correct bacteria from the beginning whereas the probiotic/inulin combination needs time to develop the health promoting bacteria while diminishing pathogenic bacterial burden.
It is worth mentioning that probiotics have also shown benefit for people with PD who have constipation as discussed here :
ncbi.nlm.nih.gov/pmc/articl....
Here is a relevant quote from this systematic review and meta analysis :
' Our analysis suggests that probiotics can be used to improve the constipation and motor symptoms for patients with Parkinson’s constipation, possibly by reducing the inflammatory response and improving gut-brain axis neuron function, whose safety also proved to be good. '
Lastly, many people with PD are deficient in the anti inflammatory mediator IL-10 and the study showed that the combination of the 30 billion CFU probiotic and 5 grams of inulin, significantly elevated IL-10 levels. PwP are also noted for SCFA deficiencies and this may be a safe and effective way of ameliorating those deficiencies and improving overall health.
My take away from these studies and reviews is that this supplement combination may be able to replicate some benefits associated with FMT for PwP and other health issues. Since FMT is currently hard to come by in most parts of the world, this seems like a combo worthy of consideration for at least its constipation alleviating action as well as its significant MDS UPDRS ll and lll motor symptom improving effects. Keep in mind that in the 3 studies from the meta analysis that showed significant MDS UPDRS ll and lll improvement, it was just a probiotic without the 5 grams of inulin. Here is a link to one of those studies :
journals.plos.org/plosone/a...
Here is a relevant quote from the study using only a 30 billion CFU probiotic (HEXBIO)without the 5 grams of inulin :
' Within-group analysis showed significant improvement in the GTT at 8 weeks, in the probiotic group from 125.26 (SD54.81) hours to 77.32(SD55.35) hours, p <0.001. No significant difference was observed in the placebo group. The MDS-UPDRS II (MDS UPDRS III median NMSS and median PDQ-39SI scores in the probiotic group significantly improved compared to baseline. For the placebo group, there was significant improvement in the NMSS scores (p = 0.007) compared to baseline, but no significant improvements were observed in the PDQ-39S, MDS UPDRS II and III.'
Here is a link to the company that makes the probiotic used successfully in the PD/ Probiotic study :
I am testing a different probiotic from Amazon that I linked to higher up in this post .
Given all of the above, it just confirms to me that this supplement combo can have some significant positive health effects that are quite similar to FMT and we won't have to wait 10 or more years, wait for a trial in which you may end up in the placebo group or go to China for a chance to try it. We can try it right now if we wish to!
Art
The Effect of Curcumin on Idiopathic Parkinson Disease: A Clinical and Skin Biopsy Study
