My long-time readers may remember my tirade from almost 4 years ago re: the FDA denying patients the right to use natural treatments like helminths and fecal microbiota transplant (FMT) as they see fit. I had been (and still am) incensed after reading a 2014 article in a legal journal, “Of Poops and Parasites: Unethical FDA Overregulation.”[i] From that article: “Thousands of Americans suffer from illnesses untreatable by presently available therapies. And while unapproved treatments may exist and even be known to be efficacious, the FDA persists in making them unavailable (ex. clinical trials are not finished), leaving no choice for the doctor, and no choice for the patient.” Currently, FMT is only permitted by the FDA for the treatment of Clostridium difficile infection, even if a doctor wants it as an option for treating patients.
That post came to mind this weekend when I read a new review article in BMC Psychiatry on the use of FMT to treat psychiatric disorders. [ii] It especially hit home because my own son, Alex, who if you’ll remember, is diagnosed with autism, has been suffering horribly with debilitating anxiety the last year. And in my work teaching nonspeaking individuals with autism how to communicate via spelling, I see daily their suffering from OCD and anxiety. It breaks my heart. (You can read more about autism and anxiety here.)
These researchers culled through the medical literature and found 21 clinical studies that met their inclusion criteria. Spoiler alert – I’m giving you the conclusion first: there is “strong evidence” that psychiatric illnesses like anxiety and depressive disorders can be treated through this non-invasive method, with negligible side effects.
Here are some highlights from the article:
This then seems to be the only issue: the treatment likely will need to be repeated every 3-6 months.
The exact mechanisms of action are as yet unknown. Some of the prevailing theories have to do with serotonin production, immune response, short-chain fatty acid production, and bacterial metabolites affecting vagus nerve signaling to the brain. I won’t be surprised if all these play a role: time will tell. What we do know is that it works, it works well, side effects are negligible. As these authors point out, antidepressant medications are also highly effective but, “…a large proportion of individuals with psychiatric illnesses do not respond to these first-line treatments, and thus need to try alternatives]. Further, many antidepressant users also experience side effects such as restlessness, nausea, vomiting, anxiety, insomnia, sexual dysfunction, gastrointestinal cramps and diarrhea, and headaches that can make the arduous process of searching for effective treatments even harder.”
Thus, they conclude, FMT is a “promising candidate” for treating psychiatric illness. (Ya think?) We can only hope that those of us with such issues, or with a loved one suffering, these treatments will soon become available. If I could treat Alex today, the door would not be hitting me on the way out.
[i] Young, KA. Of poops and parasites: unethical FDA overregulation. Food and Drug Law Journal. 2014;69(4):555-574.
[ii] Chinna Meyyappan A, Forth E, Wallace CJK, Milev R. Effect of fecal microbiota transplant on symptoms of psychiatric disorders: a systematic review. BMC Psychiatry. 2020 Jun 15;20(1):299. doi: 10.1186/s12888-020-02654-5. PMID: 32539741; PMCID: PMC7294648.