Fecal Transplants for C. difficile and More

Welcome to The Perfect Stool: Understanding and Healing the Gut Microbiome. This is your host, Lindsey Parsons, and today I'll be talking with Sabine Hazen, MD, founder and CEO of the Malibu Specialty Center, Progenobiome, and Ventura Clinical Trials, where she conducts and oversees clinical trials for cutting-edge research on various medical issues. She's board certified in gastroenterology, hepatology, and Internal Medicine and is a top clinical investigator for multiple pharmaceutical companies. She also acts as the series editor of Practical Gastroenterology on the Microbiome, a peer-reviewed journal that reaches 18,000 gastroenterologists, and is the lead author of the 2020 book Let's Talk Shit: Disease, Digestion, and Fecal Transplants. But before I get started, if you haven't yet followed or subscribed to the show, be sure to do so. And if you want to get transcripts of the podcast, pop over to my website, HighDesertHealthCoaching.com, and sign up for my newsletter. You'll also get my free ebooklet, Finding Your Root Cause Through Stool and Organic Acids Testing, when you sign up. And if you haven't yet done my quiz on which stool test would help you get to your root cause, you can find a link in the show notes and take that. Now onto the show.

Welcome to the podcast, Dr. Hazen.

Thank you.

Thanks for coming on.

My pleasure. Thanks for having me.

Yeah, my pleasure. So your book, Let's Talk Shit: Disease, Digestion, and Fecal Transplants. I noticed when I, when I was looking at it that one of your co-authors is Thomas Borody. Yes. Who has been doing fecal transplants for years in Australia, right?

Yeah.

Yeah.

The master and pioneer of fecal transplant.

Yeah. Well, so funny story about him. I, I've been obsessed with fecal transplants and this whole field for years, well before I was working in it. My previous career was in international education and I was actually working at Georgetown University in the Center for Australian, New Zealand, and Pacific Studies and realized that there might be a way, 'cause we used to bring in visiting scholars and people to do talks and such, realized there might there might be a connection there since he was from Australia in which I could somehow reach out to him.

Oh, that's funny.

That's funny. So I did. I, I, I like dug through old papers. I found his email and I wrote him and invited him. Well, I asked my boss first who was interested in the topic because he actually had some GI issues himself and I invited him to come and give a talk at Georgetown and he agreed to it in theory. But then I left that job and I'm not sure, I don't think that ever happened in the end.

Yeah, he's a great guy. He's definitely responsive to anybody calling him. Over the years, I And I'll tell you how many gastroenterologists have said to me, oh my God, Dr. Baroti held my hand on my first fecal transplant. I was so scared. Patient had C. diff and was, the colon looked awful and I was so scared to just put poop in there. And he just held their hands and that's what he does. He's been a mentor to so many of us and he's so open with his ideas and his innovations and, probably too much because people take advantage of him and use his idea to make a business out of it. And, you know, I kind of started collaborating with him and I said to him, we need to educate the people on what's coming and we need to educate them on the microbiome. But I, I don't think, and it happened during the period of COVID in January 2020 where, you know, I thought the end of the world was coming is when I finished my our book with Shelley Ellsworth, who basically helped us. And when we finished the book, I said, I'm not going to call it Let's Talk Microbiome. I'm going to just call it what it is. So people are aware because this is an emergency. And also in the book, there is a chapter that gives you an idea of how to survive COVID. So, and we actually mention in there the microbe that we believe could be protective against COVID. So, and in fact, there's a publication coming from my lab with those microbes, lost microbes of COVID-19, and one of— and that microbe is in there.

So— And what is it?

So we started talking. So if you go into, I forgot which chapter it is, but at some point, the first third part of the book, I talk about the importance of Bifidobacteria and how people that have obesity tend to have low Bifidobacteria. And if you think about it, that's the same population that's been hit with COVID right? And so, and the first bacteria that kind of popped up as being lost in patients with severe COVID was actually Bifidobacteria.

And that's also something that decreases with age, right?

Yeah. And also something that decreases with age, is decreased in autoimmune processes. You know, it's a very important microbe that is in our gut. In fact, It's the microbe that sustains the whole billion-dollar industry of probiotics, right? If you look at the back of all these probiotics, it says Bifidobacteria. If you look at kefir, it says Bifidobacteria. How many products on the market say they have Bifidobacteria, right?

Right, right.

And so that was the beginning. So to me, it was so important for people to read the book because I said to myself, this is going to give them an idea about gut health and how to survive COVID and at a time where we didn't even have vaccinations or any treatment. And so that's why I wanted it to be a catchy name. And also I figured I'm embarking in a world where I'm challenging the narrative a little bit. Dr. Baroti and I are— we're scientists. So we are the rebels that are going to look the other way when everybody's looking to the right, we'll look to the left for the solution, right? Because if everybody looks to the right, then you never find anything, right? So imagine like you're looking for gold and everybody's looking in the same spot. Well, you're never going to find anything.

Yeah. So how did you get involved with FMT? How?

It was interesting. So my friend, Neil Stolman, who was my mentor and a couple years older than me, and when I was in resident, he was a fellowship. He was in fellowship of GI at University of Miami in Jacksonville. In Jackson Memorial Hospital. And he was kind of like— I looked up to him as a GI doctor and I wanted to be like him when I grow up, kind of thing. So I went into GI because he mentored me, because I was always impressed by his way of being a physician and his vision that nobody's really right about anything, that we need to be looking constantly for, for solutions. And no, and no science, no research is wrong. Everybody has opinion. And so when I was a fellow at University of Florida, he took me around the posters. I was presenting my own poster. It was visceral hyperalgesia at the time. And he took me away from my poster and he said, look, look at this data. The future is in the microbiome. But he didn't say it like that. He said, the future is in shit. And I said, Neil, if you bring me down that path, I'm gonna hate you. And, uh, And basically what happened is he went that path, right? He started speaking. He would always invite me to all these meetings, ACG, and he was always like the main speaker. And I remember, and I would do the clinical trial side that was cleaner, you know, with pharmaceutical companies. I would basically do the new antibiotic for C. diff and the new pill and this and that. Then when the pill wasn't working or the clinical trial wasn't working, I would go to fecal transplant. And back then it was a long— I remember calling him for my first case that I was doing. And because I didn't call, you know, I didn't know Dr. Baroti at the time and I didn't, wasn't going to call Australia. So I would call Neil and I would say, Neil, how do I do this? He goes, figure it out. You know, I read all the literature and then I figured it out and I figured out my own little protocol per se. And my first case was a physician and I was shocked. You know, when you see a colon that's a disaster inside with ulcers and bleeding and mucus and you go, oh my God, I'm just gonna put stools in there and then it's gonna improve it. And then sure enough, a week later, a month later, the patient is better. They stopped having diarrhea and something happened, right? And that was the first case for me, but I still didn't like doing it because I had to put Noxzema in my mask. Nobody likes to play with stools.

Yeah.

So I was still the clinical trial girl. And if the clin— and I would tell my patients, look, I'm gonna put you in a clinical trial for C. diff. And if the trial doesn't work, then I'm gonna put you, I'm gonna do fecal transplant on you. And I would use the funds from pharma to basically pay for the analysis of the stool donor and everything. In other words, like they would pay me to conduct the trial. And I would use that money to look for perfect donors for these patients and their families, or using the spouse and making sure that the spouse was clean stools, right? And that's how when clinical trials became fecal material in the capsule, one could say me and Neil kind of joined forces because clinical trials became fecal transplant in a way. And so I joined the shit business, you know, and then I said, well, you know, if we're going into the pharma world, we better start looking at these, I better start looking at these microbes carefully because what the complication of fecal material in the future and what are we doing long-term to the patients, short-term, long-term. Certainly, I saw cases of personality changes with fecal transplant, BMI changing post-fecal transplant. Inflammatory changes post-fecal transplant. And then you start reading from other physicians, Colleen Kelly and Sahil Khanna and Paul Fuerstad, and you start reading all these other improvement or side effects, right? So you start educating yourself and you have all these questions that are not answered. And when those questions were not answered for me, I started wanting to understand the microbiome. More personal in a way, because in my family I had family members that I wanted to understand what was going on in their microbiome. And when I sent their stools to different labs, I wasn't getting the same validated results. And, and not only that, but even in the bioinformatics pipelines, the bioinformatics pipelines were different. And so I asked the questions, well, how do we know what's working and how do we know what we're doing if the pipelines are not even validated? And stool labs are not even validated. And so, I set myself on a mission to understand the microbiome, especially after I had a case of Alzheimer's where the patient remembered his daughter's date of birth after fecal transplant. And I did it for C. diff. I published that paper. It actually took probably about 5 years to get approved and published because they didn't believe that the patient remembered his daughter's date of birth. I actually had to send him the Mini Mental Status of the patient with the square and the triangles that are drawn perfectly fine. He went from a Mini Mental Status of 20, 21 to 26 and then to 29 after 6 months. So, to me, that was like one of those N of 1 that you go, wait, something's happening in the microbiome with Alzheimer's. We got to pay attention.

And then he had C. diff. That was why he was—

He had C. diff. That's how we were able to do it.

Right, right.

And so presented that case to all my colleagues and they're like, wow, that's an amazing case, but that's an N of 1. We've not seen that. And then, and of course, you know, you saw the, the case of Colleen Kelly with alopecia areata in 2 patients. And then next thing you know, the patients grew hair and you had to ask yourself, well, what grows hair in the microbiome space, right? Because Dr. Baroti tried to do that on another patient and it didn't work. So, which makes you wonder, well, maybe donor matters, maybe the microbes matter that we're implanting. And so, that was the importance for me to create Progenibio with the interest. And I realized, you know, I was shaking the beehive a little bit, you know, because every time you start something that's new and it's a physician on the frontline of clinical research doing it, it is shaking the beehive of what's already there, right? Because if you find answers, then we may not want to, you know, there's a whole industry that's going to be gone, right?

Right, right.

Especially if, let's say, we find answers for Crohn's disease in the microbiome space. Well, will the biologics disappear from these pharmaceutical companies? But I always believe, and that's always the fear, and that's why there's always like powers that be that try to destroy the innovations, right?

Right.

But I'm a big believer that the same way that the post office works and email works, we didn't decrease the work of the post office by bringing on emails. We just expedited the mail transfer back and forth between people in writing. Right.

And then started mailing everything in packages and ordering everything.

Yeah. But the mail, the mailmen are still busy. And, you know, I always joke, I say, We used to think like, well, we create internet, it's going to remove the need for the post office and it's going to remove the need for books and library and papers, right? But the reality is you have— you're busy in the real world and you're busy in the virtual world. You know, my desk is full of papers and my email has over 2,900 emails that I need to deal with. So I've got this stack of papers on my desk that I need to deal with and I've got these stack of emails I need to deal with. So I think in general, we've complicated our lives as human beings, period.

Yeah. The pharmaceutical companies will find something else to work on if they, if they don't need the biologics anymore. Well, you know, I don't think that we're here to help pharmaceutical companies, right? Yeah.

We're here to help improve them, improve their outcome. You know, in medicine, it's never a one-pill solution. It's never a one-treatment solution. You know, you have patients that respond to Remicade, for example. But then they need nutritional supplements. They need psychologists to deal with their trauma that started off the stress level that created potentially the dysbiosis in the gut, right? So, mm-hmm. It's never a one-pill solution. It's never a one treatment. That's why a lot of these patients, they need their psychologist, they need the nutritionist, they need their acupuncturist, they need and all the ancillary support to help them function because it is a complex disease for a lot of people.

Yeah. So I think— Let me, let me stop you for a second. I know most of my listeners are struggling with gut health issues or else you wouldn't be listening to a podcast that is this inside baseball on gut health.

So I just wanted to let you know that in addition to being a podcaster, I work one-on-one with clients around gut health issues like IBS, IBD, SIBO, SIFO, or invasive candidiasis. Constipation, diarrhea, soft stool, food sensitivities, and other health issues like autoimmune diseases, skin issues, chronic fatigue, and fibromyalgia. I help clients locate the least expensive lab tests that they can order themselves online to determine the root cause of their issues, then educate them on protocols used by practitioners to address those issues. The first step in seeing if health coaching might be right for you is setting up a free 30-minute breakthrough session with me, and you can tell me what you've been going through, and I'll let you know if it sounds like something I think I can help with based on what you've already tried. So you can find a link to set up a free session in the show notes.

And just ask, how successful is FMT as opposed to antibiotics for C. diff?

Very successful. So antibiotics, so what we've come to discover at Progenobiome is that if you look at the genetic sequencing of the microbes of individual, you will notice that a majority have non-pathogenic C. diff in their gut. As their fingerprint, right? So, if C. diff is in my— and in fact, it's in my gut. It's in all the GI doctors that have analyzed their stools. So, one wonders, well, did we get colonized with C. diff? You know, we're exposed to patients. Did I get C. diff somehow in the GI lab touching the handle, touching the doorknobs, et cetera? Is it part of our signature microbiome, right? If it's been part of our signature, and I really believe that it's been part of of our signature for thousands of years. I think we all have C. diff in our gut as a baseline microbiome. Because if you look at C. diff, it's 10 million years old at least, right? They found it in one of the studies I remember seeing. So if you've got C. diff in your gut and you're taking an antibiotic, what are you doing with antibiotics? You're basically depleting the other microbes, right? So you are allowing in a way C. diff to become pathogenic, to secrete its toxin, right? So, because if you look at the microbiome of patients with toxigenic C. diff, you will notice that they have a lower diversity than everybody else, right?

Mm-hmm.

How did that diversity get killed? Well, it got killed with the antibiotics we gave them.

Right.

So what am I doing when I give vancomycin? Well, I'm killing the diversity of the microbiome. So, if you look at patients with vancomycin, their diversity is much less than a healthy individual and even lesser than a patient with C. diff because you just gave them the antibiotic. So, what are you doing when you do fecal transplant? You're not killing the diversity. You're replenishing the diversity. So, the message here, why is fecal transplant helpful with C. diff is because we're replenishing the diversity of the human being. We are giving the human being a new garden in their guts. We are removing the weeds, which was the toxigenic C. diff that was taking over the gut because we killed everything around it. Imagine it's like basically you've got this group of microbes and you just killed off all its families. Well, what is it going to do? It's going to try to kill the host now, right? You just killed off all its family. So now what do you do when you're replenishing? You're replenishing new families. You're calming that little microbe at a simplistic way, right?

Mm-hmm.

You're, you're appeasing the balance of the microbiome system. And therefore the individual is healthy again.

And do you use antibiotics prior to doing the fecal transplants?

Yes. So you always wanna kill off as much as everything because you're gonna give a new microbiome.

And how long do you use and which one?

So I usually, I usually do either vancomycin or fidaxomycin, depending on coverage of the patient. Sometimes I'll do Flagyl. It's not really great, mostly 'cause most patients can't tolerate it, but usually vancomycin or fidaxomycin.

For how long?

For 10 days, 10 to 14 days. And then basically I do fecal transplant.

And are you finding it hard to find donors who are qualified? Like, will you take a donor that has C. diff? No.

No.

Presumably not, right?

Wait, wait, wait. You mean non-pathogenic C. diff?

Yeah.

Oh, I'm gonna find— yes, all donors have non-pathogenic C. diffs in their gut.

Okay.

In the genetic sequencing. And this is a very, very important thing to mention. Toxigenic C. diff is the C. diff that secretes the toxin and therefore causes diarrhea. Non-toxigenic C. diff is just a fingerprint of the microbe that's that's really doing nothing in your gut. So even if you find it in the gut, doesn't mean that it's doing anything.

Is it a different strain then? What's the name of the strain?

No, it's still the same bacteria, but it's not potent, right?

And how can you discern that in a—

Well, you, in a genetic sequencing world, you have to do a messenger RNA pipeline to basically see if it's reproducing. In a clinic, and that's in a research world. In a clinical world, you have to do a PCR to see if you have toxigenic C. diff.

Okay.

So who does that test?

Oh, anybody does that test. All the GI doctors do that test. So if you have diarrhea and you're basically, you know, you're gonna go to your doctor and your doctor's gonna do a C. diff by PCR to look for, for toxigenic C. diff. Okay.

Got it.

And they're looking at that point for a specific strain that stimulates, that basically they, if you've got the diarrhea symptoms and you've got the C. diff positive by PCR, then by all, that's C. diff in the patient. What we look at is the genetic imprint of C. diff. That doesn't mean that that C. diff is doing anything. It's most likely doing nothing, especially if the patient is asymptomatic. When you look at a patient and a donor, you have to do a whole bunch of work, a workup, right? So the first thing is obviously you do a GI panel. You know, you wanna make sure you don't have C. diff in that donor, toxigenic toxin A and B. So you'll test for C. diff toxin A and B. You're gonna look for adenovirus, Campylobacter, E. coli, Entamoeba histolytica, E. coli, Salmonella, Shigella, Vibrio vulnificus, cholera, your, you know, there's a lot of bugs that live in the gut. You want to make sure they're not active in your donor because if you give those stools to a donor and there's a lot more microbes, obviously, especially now with COVID you have to make sure the donor doesn't have COVID, right, in the stools. Because if you're giving it to an immunosuppressed patient who has C. diff to begin with because he's immunosuppressed, you could kill him. And that's why we've seen the 4 cases post-fecal transplant that died.

4? I didn't realize there had been 4.

Yeah.

Was that from that same single donor? No, no, no, no.

There were 2 other cases that were brought up in the last, probably in the last 2 years, I think. Oh, yeah. There's been 4 cases altogether.

And were they, were they from, I, I think the originals were from E. coli, right?

Yes.

And what were the others?

The other, I, I can't remember what the other 2, but I remember it was like 4 cases.

Okay.

I don't think the other 2, they even knew what it was. They were concerned about, you know, the patients were extremely immunosuppressed to begin with. So you don't— in those patients, you have to try no matter what the risk, to look at risk-benefit ratio.

Right.

But definitely that brought up the idea of looking for vancomycin-resistant E. coli, and that looked up, and then That's basically why we are doing all these tests. And now with COVID look, we were looking for a donor recently in one of my patients that had C. diff, and I used her daughter as a donor, and lo and behold, I found COVID in her stools, you know. So, you know, I can't donate it to her elderly mother with COVID in the stools. So, you know, so it is becoming challenging to find good donors. It is also becoming challenging because with COVID the microbiome changed. With potentially vaccination, maybe the microbiome is changing. With the stress that people underwent, the post-traumatic stress from COVID and the quarantine and the wearing masks, the microbiome changes. Certainly wearing these masks all day long full of infections, you know, is not really helping your microbiome because it's— they're infected and you're just breathing in all all these germs that are in the mask. So, so all that affects your microbiome, in my opinion. And, and so it is difficult to find good donors right now.

Yeah. Yeah, no, I've, I've had a few people who have come to me wanting to use a relative for fecal transplants, just doing it on their own. And, you know, I told them what tests to run and invariably they show up with H. pylori and with C. diff and with all these other things. And I, I'm like, I can't recommend that you use that person.

Well, that's it. That's the problem, right? I mean, it's like that daughter that was healthy to begin with, but then I found COVID in her stools, right? So I'm not going to be giving a stool donor with 4,000 copies of COVID that I found in the stools to a little elderly woman. God knows that, that would shut down fecal transplant really fast. So we have to be careful. And it's funny because even The procedure, you know, we joke in the GI lab because sometimes we're sterile, we're very clean in the way we process putting the stools into the colon, right? And things happen and you're like, I can't believe I'm that sterile because I'm dealing with poop to begin with. But we have to be sterile because unfortunately the microbiome is a fragile, it's not meant to be put back, right? Fecal material is meant to be out. That's why God created us to have colons that evacuated our secretions, right? Our, you know, the bad stuff from our bodies get out, right? So, that's the whole process of putting it back into the earth, right? And then, the earth processes it, all these microbes, right? It was never meant to be put back. The fact that we're finding some improvement with C. diff, To me, I think that C. diff was really the can that got opened to look at the microbiome and to look at the destruction that we're doing. To say, "Hey guys, you're killing the microbiome and C. diff is popping up in these people." And all these bugs, by the way, that are super resistant, these virulent bugs, bugs don't just become superbugs.

Right.

Unless we do something to them to make them superbugs. And I think that's the most important thing to, to reflect on, right? Especially with COVID COVID, that just didn't happen, right? The human microbiome has got to be pretty messed up for COVID to penetrate and create disease to begin with or create people to die. So when you look at the people that are affected, the autoimmune people, the people with cancer, the people that are elderly, early, the people that are overweight. There is a picture there that tells you dysbiosis of the microbiome, penetration of COVID Penetration of COVID wouldn't happen if that dysbiosis didn't happen. If you have a— I really believe that if you have a strong microbiome, and those are the people that are fascinating to me to study, and you've probably seen me on Twitter saying, if you've not been vaccinated and you've not got I'm not getting COVID, please call me. I think these are the people that are super fascinating to study because in my opinion, they hold the mystery to why they survived COVID.

Well, that would be my sister.

Yes. I'd love to test her stools because those are the people that are—

I'll send her your way.

Yeah, no, I mean, it's fascinating because I've kind of, I've been the guinea pig on this pandemic. And, you know, I test my stools on a regular basis cuz I own the genetic lab. And I have to tell you, it's fascinating to see my microbiome progress over time during the pandemic. I mean, it's been fascinating to watch. So, cuz I test, you know, if I take a medication or if I take a, or if I get a vaccine or if I get anything, I look at my microbiome. What is my microbiome doing while I took something?

And yeah, what kind of, what kind of differences do you just see? Over time?

Well, that, that's gonna be published. I can't really talk about it, but, but you are, you are gonna see it. 'Cause like I said, I am doing my timeline and I've been following myself and what I've done and what it's done to my gut. But I think also we've been following the guts of a lot of people and we've also looked at before the pandemic, we were, we had probably over 1,000 stool samples and we're gonna be looking at after the pandemic to kind of say, okay, well what is different, right? Because I think that's fascinating data as well. And also correlating with those patients, whether they got vaccinated, whether they got treatment. Some people are taking hydroxy, some people are taking ivermectin, some people are taking, are getting boosted and vaccinated. So it's important to look at it to see what is all that doing to the microbiome and then get a better idea of what the future's gonna be and how to survive the next bugs because you can imagine if you've gotten COVID, there's obviously a dysbiosis in your gut that predisposed you to having COVID. So now the next virus that comes around has a potential of becoming super virulent in that person. So that's why when you follow people who have gotten COVID the first time, then they get COVID the second time, if we don't address the microbiome dysbiosis, You're never, it's a domino effect constant until, you know, you wake up one morning with an autoimmune process or something and you go, well, what happened? Well, the domino started way back when you had COVID the first time. That was your first sign, right? It's like C. diff patients. You hear of the story of a patient that gets C. diff and then down the road they end up and they're given antibiotics and then down the road they get an autoimmune process going on. You have to wonder, did C. diff, was that the beginning? Was that the sign that said, you know what, C. diff was my first sign of dysbiosis. I should have paid attention.

But I mean, 80% of Americans at this point have had COVID. So I mean, how can you say that that's all dysbiosis generated?

Well, is America a dysbiotic country? Sure. Is it?

But what percentage of people in other countries had, I don't know those numbers. Are they getting lower infection rates? I mean, that's the question.

Those are the things to look at. I mean, certainly America is high in processed food. They certainly take on a lot of microbes. They're eating tomatoes in December. You look at Europe, not so much. They don't mix microbes so much. You look at the American way of life, high stressful, high go, go, go, not as much as, you know, if I look at the Spanish population. And again, Spain is becoming more America today. But if you look at the olden ways where people used to sleep from 2 o'clock to 3 o'clock and rest, and it was like work, family, and pleasure. Now we've become a society that's just go, go, go. We're on our cell phones constantly. We're not at— we're not doing any yoga, meditation, breathing. We're not outdoor in nature. We're not gardening. Certainly when you look at kids, with ear infections, and you see kids in the classroom have more diseases and more infections than kids that play in the, in the gardens, right? I mean, we've certainly seen those studies where exposure to microbes from the earth definitely protects these kids, right? Is the American population big on going outdoors, hiking, playing with the earth, gardening? Not really. So 80% of the population, if you look at that, if you look at the statistics of American public, probably the 80% that got COVID is because they were not doing all these things. I can tell you that just with the people that I've treated, because I'm correlating that, the people that do amazingly well are my farmers and, and my gardeners. You know, I have like husband and wife where the wife is gardening constantly. Got COVID, mild symptoms. And then the husband's a physician and he's high stress. He barely, he barely made it. So I think severity of symptoms is also probably correlates to lifestyle and stress factors. And definitely, you know, and the stress from the news and listening to the television and, you know, the drama, the conflicts and all that. What is all that doing to your microbiome?

Right?

Okay.

Well, let me, let me stop you. Let's, let's dig into some other gut issue stuff. So— Yes. With the testing you've done, have you noticed that there is a pattern of bacterial dysbiosis for certain diseases?

Yes. So, but nothing I can really discuss because it's all preliminary data. So with me, you always hear that because remember, all data needs to be valid, verified, and reproducible. There's definitely a lot of interest. I wouldn't be continuing this if I didn't see something. But we are looking, we're looking aggressively, you know, in diseases like Parkinson's, Alzheimer's, autism, ALS. That's all interesting to me.

Yeah. Okay. Now, on your website, on Progena Biome's website, I see blurb that says, want to learn more about gut refluoralization? Contact us below and we'll follow up with you. So I'm wondering, are you, do you have options for FMT for people who don't have C. diff?

We, we do not. We work with the agencies, we work with the FDA, we submit what's called an IND to the FDA for emergency cases. So for example, I had a case of metastatic mesothelioma. So I submitted that case to the FDA to allow me to do fecal transplant. They approved it and we did it. So that was a one case. We got allowed to do autism in one child. We are trying to get approved to do 30 kids. We've been working at it, mind you, for the last 2 and a half years. So, it's very— it's time-consuming. It's extremely expensive to put these protocols into the FDA. We're lucky because I'm a research center. And so, therefore, I have a portal with the FDA that I use to submit all those INDs. However, it is expensive. It's a lot of back and forth with paperwork. I think, you know, if you look at Alex Karouts and there's a lot of videos on the microbiome, the Malibu Malibu Microbiome Meeting. There's a lot of videos cuz I do a lot of lectures with doctors that are doing fecal transplant. There's gonna be lectures from Sahil, Dr. Sahil Khanna, Dr. Baroti is gonna be on that website. So I encourage everybody to go to the Malibu Microbiome Meeting.

Okay. I'll link to that in the show notes.

Yeah.

And this way they can see the videos. Neil Stolman does a great lecture on Microbiome 101 for anybody that doesn't No. Refloralization, I put it in there because it's a, it's a vision of what I believe the future to be. I didn't like the term fecal transplant. I know it's been re— re-termed. Alex is calling it, Dr. Koryutz is calling it microbiome transplant, which is a more appropriate term for it. I like refloralization because I believe we come from flora and we go back to flora. You know, the process of dying is our microbes in our gut get stronger and then they decompose our bodies back to the earth. So, to me, that's— we go back to the earth, those microbes go back to the earth, the foods we eat come from the earth. So, essentially, we're feeding ourselves constantly with microbes from the earth. So, from the earth to the earth. So, I believe that in the future, it's probably going to be more of a re-floralization procedure in the sense that finding what's out of balance and replenishing it by what's to create the balance. I think that's the pharmacy of the future. That's, that's my vision. So that's why I put the term re-floralization. We are seeing certain microbes are improved with certain nutrients and certain vitamins and certain products. So that all plays a role in the re-floralization process, in my opinion.

So assuming, you know, most of the people who are listening to this podcast, they don't have super healthy microbiomes, but assuming they can get back to a state of a healthy gut microbiome, what would you recommend for people staying that way?

Well, I think if you, if you are healthy, then keep doing what you're doing, right?

Yeah.

If you're, if you're healthy, don't do anything cuz whatever you're doing, you're doing great. Especially if you have a longevity in your family, don't mess that up, right? If you're unhealthy and you have a family history of heart disease, et cetera, well that's time to take charge of your health., right? And that means starting to educate yourself, seeking nutritionists, seeking naturopaths, seeking functional medicine doctors, seeking someone that will guide you in a good way to a proper nutrition and also help you with, you know, I like to call it the fermentation of your gut, right? So gut health really is what it's all about. And gut health is not necessarily the same for every culture, right? Because you could see a Japanese is eating Mexican food, he probably won't tolerate it. And a Mexican person eating Mexican food will not tolerate Japanese food. You know, certainly I've been a gastroenterologist long enough to know that there's certain foods that people don't tolerate. You know, we're— and I think probably we're born with a certain predisposition to eat foods from our culture and our races. And I think that's the— your comfort food, you should stick to the comfort food. I think anytime people try to change What's working is when they get themselves into problems.

Okay. So I, I've had this theory for a while that issues with vaccinations are often related to antibiotic use and a dysbiotic microbiome. Do you have any insight into that?

No, I stay away from vaccination or discussing vaccination cuz I wanna stay alive. Not that anything would happen, but to me, but you know, vaccination is a complex product. It's a complex issue. I don't think anybody's really looking at it. I think it needs to be looked at. I think anytime— look, what we learned from antibiotics 25 years ago, antibiotics was given for everything, right? And what we learned from antibiotics is that actually if you take too many antibiotics, eventually you're going to have a little bug called C. diff because you've killed all your microbiome. You've killed your gut. I think it's definitely established now. And people understand that if you take antibiotics, you have a risk of killing your gut. And that's why the whole probiotic movement came on because if you're killing it with the antibiotics, you have to promote, you have to promote your gut with the probiotics, right? And thus the movement of the yogurts and the drinks and the probiotics et cetera. I think there's gonna be a time that we're gonna figure out the same thing with chemo drugs. If you kill the tumor, you gotta work on the gut to support the killing of the tumor, right? Because you can't just kill, kill, kill. You've got to replenish. And again, the same thing we were doing with C. diff. We were trying to kill, kill, kill with antibiotics, but instead we got people worse. What we needed to do was add more microbes. I think there's gonna be a time, a time that also people are gonna start looking at vaccination and seeing maybe there's something we're doing with vaccination that needs to be supplemented with something else to balance the benefits of the vaccination with the disbalance that could be happening in the gut, for example. Okay. And I'm not saying that there is.

Right.

But I'm just saying that I think we need to look at it because it's never a one pill solution and it's always domino effect. Action leads to a reaction with everything.

Yeah.

And then I'll just, I'll just add to that though, that I'm a, I'm a supporter of vaccination and have had my children vaccinated and myself and all that. Yeah. But I'm just, I just look at, you know, I vaccinated my kids.

I got vaccinated. Yeah.

Because there's so many people now because of the politicization of, of the COVID vaccine now that are anti-vaxxers. And I just, I feel like it's an important point to not completely deny that there's ever been any problem with any vaccination because that's what promotes conspiracy theories and all that kind of stuff.

Yeah, yeah. And I think, yeah, and I'm not a big conspiracy theorist. And you know, it's so funny because on Twitter people think I'm an anti-vaxxer because I ask questions. Because listen, I'm a scientist. So, if I'm going to have a person that comes to me and thinks they have a side effect to a vaccine, it's my job to look, is that what's going on there, right?

Yeah.

So, because it's called, you know, in my world of clinical trials, When you have any investigative product, you have— and a patient has a side effect, any side effect, be it, you know, pain in the mouth, be it headache, you have to document that. It's called an adverse event. And if they end up in the hospital or they're having something that's serious, like they're paraplegic, you know, I look at the case of Maddie the Gabay, which, you know, I got involved in looking at her. You have to pay attention to that because that's a serious adverse event. And serious adverse events, we cannot ignore them because they tell us something else in the future. So I think it's our job to pay attention to everything. I think also we have to pay attention to the people that it doesn't work for, right? So the people that got vaccinated and still got COVID, we've got to ask the questions.

Yeah.

So just because I'm asking the questions doesn't mean I'm anti-vaxxers. It just means that I'm a good scientists for asking the questions.

Yeah, yeah, no, I, I, I and my children were vaccinated and boosted and still got COVID, but it was, it was Omicron, so that was sort of expected since that was less sensitive to the vaccines.

Yes, yes.

Okay, so you mentioned that the people who were most susceptible to COVID had low levels of bifido, and I'm just wondering, because actually I did a— what was it— with Thorne, one of their metagenomic sequencing of the microbiome, and, and they said I was low in bifido and, and to take rice— well, they said, I can't remember the name of the actual fiber, but it was essentially rice bran.

Right.

So that's what I'm— so I'm taking that. But other than taking probiotics with bifido and, and that, what else can boost bifido?

So I have to warn on that because I never put myself in the position to kind of say, yes, we found this. It's research, right? So it's my hypothesis, it's a finding. It's a small study and needs to be done as a bigger, larger scale, obviously. So, I don't want people like leaving this and saying, "Oh my God, I've got to check my bifido to see if I'm right." Right? Because until other doctors validate, verify, and reproduce the data, it's still research of one scientist.

Right, right.

So, I think if it doesn't hurt, yeah, take whatever was suggested. But if they— if it becomes like a heavier treatment or something that is risky, I probably would stay away from, then not necessarily trust those labs. Remember, these labs are not validated and not clinical, right? They're just a consumer product that's out there, but it's not— the majority of these labs are not even CAP or CLIA certified. So it's very important when you do your stool testing, and remember, we're in the research, we're writing the data, and And we're not a commercial stool sample yet because there's so much to learn. So, you gotta be aware of stool companies that are selling you these tests and that are telling you, you have low Bifidobacteria because maybe they're trying to sell you a probiotic for one.

Yeah.

I know we have validated a couple of those labs 'cause my patients come to me and say, look, I just took this probiotic from this company and, you know, my bifida was low. And then we, we compared it and we couldn't find that their bifidos were, were low. So you gotta be careful.

Mm-hmm.

Of anything out there.

Yeah.

It's all research and everybody needs to understand it's all research.

Yeah. Well, it was, it wasn't the first low bifida reading I'd had. I, I've certainly had other, probably 16S sequencings that showed low bifida as well.

Yeah. Yeah.

Yeah.

So that's good. So you, you validated yourself.

Right, right. Over time. Yes. So are there any other diseases where you have, where you've noticed changes when incidentally you were doing the transplant for C. diff?

We are working on autism right now. We're gonna try to bring on a protocol for Parkinson's and Alzheimer's. I'm working with Dr. Sheldon Jordan at UCLA, who is the top interventional neurologist in my opinion. We're also working with anxiety with Dr. Sasha Bistritsky So that's gonna be an interesting study. We feel that we see something in anxious patients' microbiome. So we're evaluating that closely.

And are you just looking at what, what is going on in the microbiome? Are you making, you're making interventions?

No, we're looking and we're making interventions.

Through the gut biome tea? Well, or not always.

Or something else.

Okay. Yeah.

So we're, we're, we're basically, remember I'm a research center. Right. So we have access to animal labs. So we're, right now we're looking at an animal marker for Parkinson's. So we'll see. I mean, you know, the future is exciting. We're seeing some things and we're going after it full blast and we're, we've been lucky so far. So we're still above the ground as far as finances, but people can support the Microbiome Research Foundation, cuz that's how we make all these trials possible and this research possible. You know, the paper for, COVID, the Lost Microbes of COVID or Finding COVID in the Stools was paid by the Microbiome Research Foundation. So, please put that on the link so that people can support that.

Yeah.

So, that's how we advance science through research, through donations. We've been fortunate. A lot of patients I've helped over the years that have, you know, I'm in Malibu, so I have affluent population and they've been coming forward and been very generous. In supporting us. So, and also the patients, you know, the patients support us. So it's been amazing to help people.

That's great.

So, and to see and to kind of go into the research with them and see what we see and saying, look, it's research. This is what I see. I could be wrong, but I could be right. And this is the beginning, you know, and having that frank, honest discussion with the patients and giving them a consent. 'Cause really all our research is consented. Anytime anybody gets tested with us with the microbiome, it's all research. So, they have to sign a consent before they get tested. Or if we test their kids with autism, et cetera, they have to sign a consent. We are supervised by a regulatory board that overlooks all our IRB, that overlooks all our research. We're doing, you know, I talk Howard Young at the NIH said, this is the way to do it and I'm doing it. So, I wrote 52 clinical trials clinical trials on the microbiome and disease. I'm looking at every diseases and every skin condition. I'm very fortunate. My sister is the top dermatologist in New York City. I have another sister who brought Harvoni and ivermectin in the market. So we have a huge database of patients through clinical trials over the years. So we've been able to utilize these databases and put patients into clinical trials to at least get a beginning of a view of what does Parkinson's look like in the microbiome? What does Alzheimer's? So we have an idea and we're continuing slowly, slowly. And eventually, you know, as we publish, you know, I encourage everybody to go on the ProgenoBiome website because it has publications. We've published about 35 papers, I think, in the last 3 years. So, you know, it's moving. I have 52 more papers to go. We have a lot of scientists helping me and we encourage collaboration from Everyone, anybody that wants to be involved, please, you know, we're all inclusive. Like I said, I'm a research center. I'm a research lab right now, research genetic sequencing lab. I'm not a commercial, but anybody that wants to get involved and has something that they want to crack the code of, you know, can help us. And, and together, hopefully we'll join forces. I, I'm fortunate I have a lot of doctors a doctor from Turkey that I'm working with right now. We're looking at Crohn's and ulcerative colitis together. Dr. Baroti has been an inspiration and definitely a huge mentor and a huge brain and genius.

Yeah. Speaking of him, I would love to get him on the podcast. Any chance you'll, you would introduce me?

Oh yeah, absolutely. I could do an email.

Wonderful.

He's extremely busy right now cuz he's trying, we started off that controversial triple therapy for COVID with ivermectin, doxycycline, zinc. So, you know, he's busy fighting the wolves himself because he wants to see that going. You know, he was behind the therapy for H. pylori. So patents is his world, and combination therapy is his world, and he's a genius. I'm so fortunate to be working with the man. And, you know, I've done my, my part, which was like doing the clinical trial with the FDA. So now it's on to him to take it to the next level. That was not an easy trial to do and certainly a lot of, uh, controversy, politics, controversy behind it.

So, right, right.

Okay.

Well, I appreciate that.

Yeah.

Even if he doesn't have time, maybe he will eventually.

Yes, yes, yes. For sure. I think, yeah, yeah. As he kind of like figures out this whole triple therapy.

Yeah.

What he wants to do with it. I think that probably would be the best time.

Okay.

Well, thank you so much for coming on and sharing about what you're doing at, uh, ProgenoBiome.

And thank you.

I look forward to, uh, talking to you in the future sometime.

Yes, absolutely. Thank you so much.

Well, I'll link to ProgenoBiome and their website, and I just peeked over at some of the publications that were on there, and I see the one she was referring to that Dr. Baroti was involved in is called Effectiveness of ivermectin-based multi-drug therapy in severely hypoxic ambulatory COVID-19 patients. And then there's a lot of microbiome-related research as well, of course. Anyway, if you would like to connect with me online, you can follow my High Desert Health Facebook page, join my gut healing Facebook group, or join my newsletter list at highdeserthealthcoaching.com, as well as find me on Twitter, Instagram, and Pinterest. And links links for all those are in the show notes. Thanks for joining me today, and here's wishing you all the perfect stool.