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Is There A Natural and Available Alternative To Fecal Microbiome Transplantation (FMT)?

Since it looks like fecal microbiome transplantation (FMT) is not currently available to the masses, unless you live in China, 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 perform 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 :

https://www.earthclinic.com/remedies/fecal-microbiota-transplantation-exploration.html

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 12weeks :

https://www.sciencedirect.com/science/article/abs/pii/S104346662400111X?via=ihub

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 :

https://www.mdpi.com/2218-1989/13/10/1039

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 components, 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 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 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. 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, which 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.

Supplements

Here are links to the two products I am currently testing. I am not recommending these, just showing what I am currently testing. :

Inulin
300 Billion CFU Probiotic

I use one capsule per day and mix 10 grams of inulin into a  500 ml bottle that is 2/3rds water and one third orange juice. I shake the bottle well and sip throughout the day and taking the synbiotic capsule in the last half of the bottle.

In this September, 2022 review discussing the benefits of increased SCFAs, they show multiple health benefits associated with such increase :

Benefits of Increased SCFAs

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 and 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 the pathogenic bacterial burden.

If anyone decides to replicate these study results over a 12-week test period, please come back and let us know what you find. I will update you on my own experience using this combination of a 300 billion CFU probiotic, 300 mg of mixed prebiotic, and 10 grams of inulin.

Art