From FMT to Thaenabiotic: Andrea McBeth, ND on Microbiome Innovations

Welcome to The Perfect Stool: Understanding and Healing the Gut Microbiome. This is your host, Lindsey Parsons, and today I'll be speaking with Andrea McBeth, ND, co-founder of Flora Medicine, SkinCology, and Thayna, about their exciting new product, ThaynaBiotic, which is a postbiotic derived from sterilized human stool. Andrea studied biochemistry as an undergraduate with an emphasis in molecular biology at the University of San Diego and has a doctorate in naturopathic medicine from the National University of Natural Medicine. Before becoming an ND, she worked in blood cancer research at Oregon Health Science University, and after becoming an ND, she focused her clinical work on functional gastroenterology and started a fecal transplant stool bank to treat C. difficile. With a technical science background, Andrea's passion for the microbiome has led to innovations in stool-derived postbiotic applications. She has served as the president of GastroANP and is an adjunct faculty for the School of Graduate Studies at National University of Natural Medicine, teaching about the microbiome and nutrition. But before our conversation, if you haven't yet followed or subscribed to the show, please be sure to do so. 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 on to the show. Welcome to the podcast, Andrea.

Hi, thank you so much. It's great to be here.

Yeah, I'm glad you were able to come.

So why don't we lead off with a description of what Thanabiotic is so that people have some context of what we're talking about since this is such a new and different product, and then we'll get into some background and then finish up with the research and uses and such.

Sure. Yeah. So Thanabiotic is a postbiotic, but specifically the postbiotics that we extract from healthy human stool through a process that involves autoclaving, which is high heat and pressure sterilization, and then freeze drying.

And what is a postbiotic?

We've heard of probiotics, and those are the live organisms that either are cultured in food and we eat and confer health benefit. And sometimes we also think about the microbes in our gut and microbiome and in and on us as also probiotics. Not exactly, but that kind of idea. The food that they eat are the prebiotics, which we have also started to hear about. So fiber and vegetables and things like that. And the postbiotics are the molecules that the bacteria make when they consume those prebiotics. So the food that the bacteria eat get converted through metabolism into small molecules that we're now starting to look at and think about and call postbiotics.

Yes. Right. So for example, short-chain fatty acids like butyrate.

Yes.

Okay. So I think people will have some familiarity with at least that because I have a butyrate supplement that I recently put on the market and have talked a lot about it in my podcast. And how do you screen your donors for Thanabiotic? Are you doing metagenomic sequencing of their microbiomes to ensure they have good protective bacteria? And if so, how often? And how often do you screen for other things like STIs?

Yeah, so we derived this from work we were doing in a fecal transplant stool bank setting. And so we both are doing all the infectious disease testing and whole genome sequencing and defining health through a series of history and intake and surveys. So beyond, do you have bad bacteria? Are you healthy? Have you had histories of infection or exposure to antibiotics or other medications, but then also what do you eat and what is your lifestyle and were you vaginally born and were you breastfed? And you know, we still don't have a really clear definition of health, but basically our approach has been to take everything we do know and to the best of our ability identify and filter out people, super poopers that meet all the characters of a healthy microbiome with the caveat that we don't know exactly what a healthy microbiome is and there's nuance there, but We're doing the best we can. We had a person working for us for a while who was really concerned about plastics, so we added a question about, do you use plastic water bottles? Because that's one of the places where people get really high concentrations of plastics in the diet, and that's a disqualifier for us.

Okay. But specifically, are you checking to see if they have all the keystone species of a healthy microbiome, for example?

Yeah. So we have gone back and forth on how to characterize that. We look at their alpha and beta diversity, we look at the species, but we don't actually have explicit exclusion criteria because what we're concerned about is what metabolites they're making. And as we know, Akkermansia, for example, can be a beneficial bacteria and is important. But if you don't have the most Akkermansia, that doesn't mean you don't have the enzymatic genes within the microbiome to make the metabolites we care about. And so Although we are looking and collecting that data and thinking about it, we don't have explicit inclusion and exclusion, good guys and bad guys amongst the commensals, but we are trying to classify these people as both healthy in lifestyle and history and healthy in microbiome diversity, at least.

And how often would you screen somebody for infectious diseases?

So we screen every 6 months and we also have continuous conversation with our donors with the contractual agreement that anytime they sneeze or have a period of grief or anything that would perturb their microbiome in any way, we communicate and put them on pause and then we retest before bringing them back on.

And are you getting pooled donations or are you getting a product that's just coming from one person?

Yeah, so we have multiple donors and what we're doing is we're identifying within a certain sub-batch a group of their individual person's stools and pooling those. And then we can have a fingerprint of their metabolites, the end product. And then we pool those with other donors so that we're getting a diverse array of metabolites, but we're not pooling their bacteria. If that makes sense. Cuz we're autoclaving as the first step, so everything's getting killed, but at the end it is a mixture of multiple people's metabolites.

Okay.

I'm not sure I understood exactly the distinction. So you're pooling a smaller group and then you're pooling it into a bigger group.

We're subclassifying it so that we can verify that we're working within a single donor. And we're also, part of this project is to start to understand the characteristics of metabolites that are coming from different people at different time points. And so we're collecting samples along the way, but the end product is pooled between multiple donors and many, many stools.

Okay. So are the dead bacteria gone too, or are the dead bacteria in there?

There are. It really is a prebiotic, parabiotic, postbiotic in its entirety cuz it is whole stool that's autoclaved and we do some processing to pull and save short-chain fatty acids, but We're not filtering everything out. And so the end product is a mixture of a little bit of everything.

Okay. So it does have dead bacteria. Mm-hmm. Yeah. And how do you pull out fecal material then from the mix, or is it still in there?

Well, fecal material is a mixture of prebiotics and bacteria and dead cells and all that stuff.

Okay. So I guess maybe what I'm trying to get at is like a typical fecal transplant, if you did it in capsule format, you might be taking 50 capsules or something, right? So how does what's in one capsule encapsulate enough of what you need?

So early on we were like, well, is this gonna do anything? Right? Our idea was what if we could pull the postbiotics specifically in a small amount and put it into a supplement format? And when you think about fecal transplant, you think about 30 capsules or a whole bunch of stool. And what we're doing here is one capsule is roughly equivalent to about a half a gram of stool. So not. Very much at all when we get to the end product, which is about 100 milligrams of the powder. But it does seem to have a physiologic effect in terms of just the anecdotal observations we've been having as a nutrient or benefit, not in the same way that you would get bacteria engraftment from an FMT or grams of butyrate from a butyrate supplement, for example, but a whole bunch of mixture of thousands of these small molecules. In a really small amount that are working synergistically to support motility or interact with mitochondria or interact with the native microbiome and shift it from really subtle cell signaling. And to a best of our preclinical and clinical observation is that it's doing something related to small molecule nudging of less so the short-chain fatty acids, but some, but it's a relatively small amount of short-chain fatty acids. Our basic mechanistic understanding and thought right now is that it's the combinatorial effect of lots of these postbiotics in synergy at small concentrations.

Okay.

We'll, we'll get into a little bit more about what the postbiotics are in a minute, but I just wanted to dig in a little bit on what got you interested in gastrointestinal conditions and treatments.

I love the microbiome. I think it's the coolest way to frame nutrition and environmental medicine and why what we eat, drink, and think matters in the world. And my passion has always been chemistry and molecular biology. And after doing some work in the cancer space and having a family member who had cancer and going through that on the patient side, my hope was to find a way to not do that again and have prevention. And I think the microbiome is the answer to us trying to figure out how to create a world that we can live and thrive in because it's such an important organ and it is the canary in the coal mine of the environment we're interfacing with. And so I think without going on too long about my passion for the microbiome, in short, I was working in research had an experience with a family member with cancer, became a naturopath, wanted to connect all the cool things I was learning in nutrition and preventative medicine with the chemistry and the cellular biology. And the microbiome really was that bridge for me.

Yeah. I've also been fascinated with the microbiome for a long time. So I think I heard on another podcast maybe that your original hope had been to offer FMT on a wider scale or a purified FMT product on a broader scale, but that the FDA put the kibosh on that. Is that the case?

Well, we have been doing FMT for C. diff not responding to therapies for a long time, and there was always a hope that we could understand mechanistically what it was about FMT that was so special and address the infectious disease risk and scalability and some of the other things that were the limiter for using this really powerful tool because you can provide FMT to a C. diff patient who isn't responding to antibiotics and their lives change in 24 to 36 hours. And it's not just that their diarrhea goes away, they feel better, they have less fatigue. There's all these really fascinating gut-brain axis components. The autism study that came out of ASU in 2017 and the follow-up in 2019 was really profound for us. And our practice and people calling us and asking us and having to say, no, it's not accessible. We work with nutrition and supportive things all the time as functional gastroenterologists. And it was really a moment of what if it's not just the bacteria or phage or viruses, but there's another component of compost in this secret sauce of FMT that is safe and really is a food derivative or is like a probiotic. That we could provide patients in a different setting in a different way and change the paradigm and look left when everybody was really focused on what were the good bacteria and the bad bacteria. And so I think for us it was just a moment of, well, what if theoretically it was these small molecules and then COVID happened and then we couldn't provide FMT because we couldn't screen for COVID. And that was a really good reason to put the poop in the autoclave. And so that's kind of how it started. And then from there, we've gone down this path of developing something that is safe and tested and food-derived and fits more into this classification of dietary supplement so that there's another tool in the toolbox to modulate the microbiome in the same way that kind of early probiotics were brought to the market.

So when did it come on the market?

So we've been providing it as a pilot through clinical practice for a few years, and relatively recently in the last year, it's a physician-only dietary supplement that's on the market.

Okay. So I didn't get a, a straight answer though, in the sense of, was there a conversation with the FDA about, about wider stool transplant distribution and they did reject the idea?

Well, I think I've been to most of the conferences and listened to FDA Q&As and had a couple off-the-record conversations. And the clear articulation was infectious disease risk is a concern, and that makes logical sense. And when I pitch things like, well, what if we did autologous FMT? And they're like, nope, that's definitely still FMT. And then I said, well, what if we autoclave it and look at it like food? They were like, great, go do that. That's going to be really helpful. That's not a thing that we're concerned with anymore because you've eliminated the component of concern in the infectious disease.

Right.

Yeah.

I think that whole situation in the US is very frustrating to a lot of people. And I mean, I just went on the web and searched a little bit and there was a study, I think, of more than 5,000 courses of FMT. There was a total of 5 deaths. And I think most of those could have been prevented if there'd been proper donor screening.

I mean, I've always been fascinated with what is it about FMT? Like, it kind of works no matter who your donor is, so it can't be this one magic bacteria. There's gotta be something about it that's modulating the ecosystem. And I'm really excited about the Rebiotics product that's out on the market, and we've shifted to using that clinically for C. diff. The approved FMT enema they have.

Oh, I'm not familiar with that.

Rebiotics is the first approved FMT stool-derived FMT for C. diff and it's on the market and insurances are starting to cover it and it's great. It's like huge that that is now available. So like we're not gonna do FMT anymore clinically for C. diff, but Synbiotic is a bridge. It's like the next generation in probiotics. It's not fecal transplant and I wanna be really clear about that, but it came from that idea of of observing what was happening in FMT, thinking about how the microbiome is signaling health through these small molecules. And what if we could take a snapshot of a healthy donor of that signal of those small molecules? And would that impact a recipient who has dysbiosis or doesn't have those back— good bacteria? You're not engrafting or causing trouble necessarily with giving somebody something that you can't get rid of or could cause an infection, but you are providing that complex ecology that some people have and others, just because of the way they were born or their environment or their diet or their antibiotic exposure, don't have access to.

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So let's talk about some of those postbiotics. So what are the different types of postbiotics that are found in The Anabiotic?

Yeah, it's really hard for me to choose my favorite. So every day I find myself with like a different list, but the broad classifications I think is a good place to start. So short-chain fatty acids, you mentioned, that's a really good category because butyrate is well characterized and has a ton of benefit. And it's a really interesting molecule because it does things, it provides energy, but it also changes— it's an HDAC inhibitor, right? So it changes the way that genes are read. There are good things about acetate and propionate, but then if you have them out of balance, or there's some data that shows if you have too much of one, it might be a bad thing, right? But broadly, they're really interesting because they're sort of the powerhouse of the energy of the metabolism. And then there's things like indoles and tryptophan derivatives that are in lower percentages, but they bind T cell receptors. And there's all this interesting work being done looking at how these small molecules can make profound impact even at low concentrations throughout the body by interfacing with our immune cells that sit at that Peyer's patch in our gut. That mucus layer keeps the bacteria out, but these small molecules are transferring across the mucus layer and across the epithelium into the blood and into the lymphatic and interfacing with those. There's other groups like the sphingolipids. The reservoir of our sphingolipids are housed in the microbiome and they get broken down and then rebuilt. And so the cell walls throughout our body and our brain. I'm really excited for the future of research in the microbiome to start to look at where do all these molecules that the bacteria make get distributed throughout our body. And so I think those ones are really interesting. There's medium-chain fatty acids, there's bile acids. I don't know if you have a group of postbiotics that are your favorite, but they all have—

doesn't everyone?

Yeah. I mean, I, ornithine and citrulline, I have like a running list of my favorites that are in our product and someday I'm gonna write synopsis with my team.

I think what you need is a one-a-day calendar. You know, you just tear off the page.

But I do think we have this treasure trove of small molecules that we've been co-evolving with since the beginning of time that we haven't looked at yet. And it turns out they're hormones. They bind and interface with our whole body in the same way that hormones from other organs do. And it makes sense cuz the microbiome is kind of like a hormone organ that we just never saw and didn't know was there. But feel free to keep me reined in cuz I get really excited about the wonky chemistry. I mean, the big picture step away is a healthy microbiome is making a huge diversity of small molecules that are being used to transmit signals throughout the body and interface with all the different parts of our organs, not just the other microbes.

Yeah. So where is the antibiotic meant to start dissolving? In the small intestine?

So we put it in a capsule to get it linter coated, but the powder, if you open the capsule up and take it orally, it still seems to work. And I think a component of that is that these small molecules aren't just working locally in the colon. They are signaling molecules that get absorbed into systemic circulation. And that was a pretty big paradigm shift even like a year ago. But now there is evidence that bacterial-driven metabolites are in our serum, and that is a part of the mechanism of how the microbiome is interfacing. So I think it's actually not as important as we thought where these get delivered, as long as they're getting delivered to the GI tract. And there is a component of the antibiotic that is insoluble fiber and those prebiotics that are getting— but it's a very small amount. So it's not like taking a prebiotic supplement. With like 10 grams of whatever.

Right.

And you said it's 100 milligrams worth of product. So that's, I mean, I'm just thinking comparatively, like the butyrate supplement I created is 750 milligrams of butyrate alone. So it would only be a very small portion of any one thing. It's just sort of a combo of a bunch of things the bacteria would be producing. I'm just curious because somebody said at one point, I can't recall if it was on my podcast or in some other context, we're absorbing all our nutrients in the small intestine and then only water in the large intestine. But yeah, you're nodding no. And I'm thinking, yeah, no, that doesn't make any sense with what you're telling me because other than the short-chain fatty acids that maybe are feeding the lining of the large intestine, there obviously are other molecules that are being absorbed from the large intestine.

So that statement is true in our old paradigm of free microbiome nutrition, right? So if you were thinking about metabolism from a human-centric space without any accommodation for the reality of this extra organ system of the microbiome. Yes, that's true. Our nutrients that are digested, um, you know, I like to think of the GI tract, mouth to anus, as an orchestra, right? And so a component gets digested when you chew, and our salivary glands secrete things that help with digestion, and then you get stomach acid, HCl, in the stomach. Stomach that digests and breaks things down, and then a component like the amino acids, um, those get absorbed in the small intestine. So our digestion and metabolism, things get absorbed, but there's all kinds of stuff happening in the colon that's related to microbiome metabolism that wasn't included in that paradigm before. And now we have to really ask what we thought we knew and reassess how metabolism works in human health with the context of what the microbiome is contributing to the system. Because a calorie in is not a calorie out. We've seen that with the work done in fecal transplant and mice studies. We know that different people, thanks to the Weizmann Institute and fecal transplant studies they've done in Israel, that my, My blood sugar response to rice and tomatoes may be completely different than yours because our microbiomes are changing the way things get metabolized and impact blood sugar response. So I love that this product is intuitively contra to the traditional paradigm, but the fact that it does anything is kind of a miracle and a testament similar to how FMT was originally. That the microbiome is so much more important than we thought it was.

So what kinds of conditions or symptoms are people trying Theinabiotic for?

Yeah, I mean, I think our framing of it as a dietary supplement very intentionally is to not treat disease, but we are piggybacking on the work that has been done looking at how microbiomes not being healthy can impact many symptoms and aspects of life. You can think about how our GI system works. It's really interesting to see this impact motility, which is the way that our gut moves poop through the system and helps people have more frequent bowel movements. But it also makes people have less loose bowel movements in some circumstances. And the other place that we're really interested is that it seems to impact fatigue and how people feel in their brain, which kind of makes sense when you think about the gut-brain axis and all the evidence we have from fecal transplant and the role that probiotics and nutrition can play. But we are very much at the beginning stages of working with physicians and functional medicine docs to ask the question, does your patient have a dysbiotic microbiome and could they be missing some of these basic signaling because their ecosystem's depleted? And if so, would this super nutrient impact that? And the general response is that yes, it does seem to be a super multivitamin that can help to rebalance some of those things that are caused by a lack of, not a certain species per se, but the metabolism that some of those important species are doing to make something like Butyrate, for example, is pretty well covered and at a high concentration. But that same idea at some of these other lower concentration, really important molecules like the indoles or any of the amino acid derivatives and specialty bile acids.

Right, right. Yeah, that was the, I think the follow-up question that I was thinking of when you were talking about where absorption is happening. 'Cause you mentioned L-citrulline, which is an amino acid, but I guess it's not an essential amino acid, it's derived from arginine.

This is where I apologize if it's too much philosophy, but, but I come back to this concept of, okay, we evolved as an archaea and a bacteria being endosymbiosed. And if you think about human and eukaryotic multicellular organisms, we have not been around very long. Bacteria were here way before us for much, much longer. And so we just hijacked the metabolism of bacteria and copied it for our own purposes. And so it makes total sense that in the same way we think about human cellular metabolism breaking down amino acids and taking things from food and all that stuff, bacteria are doing the same thing and they are interacting with these molecules at all the different steps of the biochemical pathways we traditionally think of as a human cell pathway. And so they're breaking apart amino acids and adding things to them and changing bile acids and breaking apart fats. And you know, you're ending up with this really complex milieu of intermediate molecules that again are, you know, similar to when we think of traditional human biochemistry pathways that we think of as the Krebs cycle and things like that. But that's mitochondrial, just remnants of our bacterial cells themselves. And so that is all happening on the bacterial level within the microbiome. And so it's a sea of all these nutrients that are used for all kinds of things.

When I have clients dealing with diarrhea or loose stool, I always tell them about tributyrin, which is the best absorbed form of butyrate, which is normally made by bacteria fermenting fiber in your colon. Supplemental tributyrin can help slow your motility down and feed the cells lining your colon, firming up stool and helping create an oxygen-free environment in the colon, which helps the butyrate-producing bacteria to survive and multiply. Those bacteria are often wiped out after taking antibiotics, which is why tributyrin is a great accompaniment and follow-up supplement if you have to take antibiotics. My new supplement, Tributyrin Max, has 750 milligrams of tributyrin which is the highest dose currently available in a capsule. You can find it at tributyrinmax.com. That's T-R-I-B-U-T-Y-R-I-N-M-A-X dot com. And use code INTRO15 for 15% off your first order.

Just in case people are having trouble absorbing what we're actually talking about, I, I wanna kind of condense this down. So basically what you've done is you've taken FMT, you've killed the bacteria, and now you've put it into a pill. That pill is full of all the stuff that the bacteria was already doing in a healthy colon. But if you don't have a healthy colon or healthy microbiome in your colon, you're not doing all those things. You're not producing all those things. And maybe you're producing some of those things because everybody's still got some bacteria left, but you're not producing all of them. And so now in one pill, you've kind of got a mixture of everything that a healthy person's microbiome would be producing.

Yeah, we think about it like an ecosystem. So it's the entire ecosystem instead of of one or two cultured derivatives. So if you have a postbiotic from lactobacillus, that's like a subset of postbiotics. This is the entire ecosystem of a healthy human. And instead of using a kombucha to ferment, you're using a colon to ferment, but they're the same basic idea. It's just one's much more complex than the other.

Yeah. So I know obviously you have to avoid the health claims, but I'm just wondering if there's any anecdotal stories from users or reviews that you you can't, you can't go in that direction.

Okay.

Unfortunately not. I mean, I, are there reviews up on the website though? I mean, we're the only people autoclaving poop, so we're being really, really conscientious about this being something that is to support microbiome health. We have some really interesting data in longevity and longevity's not a health claim, so that's really fun. We have a C. elegans model, which is a roundworm. Yeah, it's a little worm that we use Researchers use to study, there's a bunch of genes that they have that we have, and there's some analogy. And so they're a really nice model because they're easy to use and they're well characterized. So what's interesting is we have looked in C. elegans, we can make them live longer and wiggle and they're more vital and their healthspan's better, even compared to rapamycin, which is a really common longevity drug, and resveratrol, which is what we think of when we think of red wine being good for you or polyphenols. So it's, anabolic works better than those in the C. elegans model for making them wiggle longer. And then when we look at the genes, it's doing things related to oxidative stress and mitochondrial health. And so by proxy, you think about everything in our body that's related to oxidative stress, and this is a really potent antioxidant. And so that's another framework for us to kind of start to think about how we can support patients with things that are happening with them on a nutrition level to support antioxidant or oxidative stress. I mean, I was really excited and I didn't expect to have data come back from the RNA-seq we did, which is a way of looking at the genes and the, the worms. And when we give them thanabiotic, it really impacts their mitochondrial genes, which is again, the powerhouse of cells and They're bathing in it, which is different than us eating it. But when we think about mitochondrial health and longevity and inflammaging, if you wanna make up a word that is thrown around a lot, that's all related to oxidative stress and mitochondrial health. And again, mitochondrial bacteria, whenever I hear longevity people talk about mitochondria, just copy paste that into microbiome. They're the same thing.

Okay.

Do you have any clinical trials planned or underway?

We've got IRB approval to work with these partner physicians in open black box observational pre-post testing, pre-post clinical data collection. So we're at the really early stages of case studies and case reports, kind of like Dr. Bredesen did with the Alzheimer work, where our hope is we can collect enough data to then write the grants to fund real clinical trials. We've written many, we just don't have the money to fund them.

There's not a placebo in this case.

No, I mean, it would be great to do a placebo-controlled study early on. That was like our first proposal, but we're a small startup. We really are optimistic with the C. elegans data that we'll be able to start to write grants. And if we have enough clinical case observations, we might be able to fund a real proper pilot study, but we have not yet, but we are very hopeful. And you know, anecdotal data is what it is. It has some value but is limited. And I'll be the first to admit from the early days, I was like, is there any way that this is actually doing something? And it's taken me many years to be convinced that something as small as 100 milligrams of of sterilized poo powder from a healthy person would significantly impact people. But there does seem to be a set of really strong responders. There are people that it does nothing for, but the people who it shifts stuff, it definitely makes a significant impact in the way that, you know, a dietary supplement that's effectively utilized really can change people's lives. So I'm cautiously optimistic. We're gonna keep learning.

Yeah.

So I, I think then the assumption would be that if you already had a super healthy microbiome and you were doing everything great, that it probably wouldn't be a big benefit to you. It's more for people who have a dysbiotic microbiome.

Yeah. I think because the longevity data is so interesting, before we had that, I would say don't take things for the sake of taking things in general and eat food as medicine has always been my mantra, but there's something about a healthy microbiome for somebody like me that I can't get anywhere else. And so it does seem to help just at a baseline, me to take it every day as a supplement in the same way that I try to eat vegetables. But I was born via C-section, I have chronic disease and like a whole host of things. And so even though I'm not acutely ill, this seems to be a support. I think the cost benefit is that conversation is there no matter what we're talking about, like Is it better to go get a massage or try a new supplement? I mean, I think that's an individual decision on cost benefit, but it's nice as a clinician to have this as a tool in my toolbox.

Right. Thinking about the cost benefit analysis and sort of long-term supplementation, I think the frustration that a lot of people have with gut-based treatments, especially if they have some kind of a condition like I do, post-infectious IBS, where I'm going to have this for life, likely. So the frustration, of course, is that a treatment, that you have to do it indefinitely in order to get results. So I'm just wondering what you think the expected course of treatment for TheanaBiotic would be, and if people can get off of it, not perhaps if they're using it for longevity, but say they're using it for diarrhea or constipation or bloating or something like that.

Yeah, totally. We have asked that question from day one and what we've observed so far based on anecdotal and several thousand patients trying this, is that you have to take it for at least a month, a few months, sometimes 6 to 9 months. And like all things, it depends how you got there, right? If it's 20 years that led you to something acute that's different than you had diarrhea traveling, but it does seem to shift the microbiome enough or impact the neuroimmune modulation enough that you don't need it anymore. And so people will try it for a while, stop it. If their symptoms come back, they try it a little bit longer. It's in increments of 30 capsules is a month dose, and then we have a 90-cap bottle that's 3 months. And so in general, 3 to 4 months, if it's working and helping, try it for that long, go off of it, and then hopefully you're at the point where whatever the underlying issue is, You're more tolerant to food. You have more diversity in your microbiome. Your immune system's less reactive. Your motility is better. You don't have to keep on it indefinitely. That said, we do have a handful of patients that have been on it for a really long time, or they go off of it, but then they keep it around for acute flares. My business partner and I were asked one time, is it like for benders or is it for prevention? And I said bender and she said prevention. At the same time. So it's great if you're gonna like wanna be resilient in the world to have a pizza and a beer, but that's not something you normally can tolerate. At the same time, you can approach it the way my business partner does where it's a prevention thing. And I think it just depends again, that cost benefit and where people are at, but it's not something that you have to take indefinitely cuz the microbiome is such a dynamic environment that if you can get it back into a state of balance with the immune system interface, that's my theoretical position that we're reducing the leaky gut, histamine, whatever, enough that you can then be maintained and at a better place. So when you think about functional medicine and your patients and my, my patients and our own IBS, you can get to a place where you're kind of good and then you plateau and then you don't have a tool.

You're doing everything right, but you're still having diarrhea every month or so, or week or so, or whatever. Yeah, I've certainly heard that with a lot of people.

And then you try something like this. That's another tool that gets you to the next place. It, it gets you off that plateau or it helps you be resilient to that next perturbation. And like all the other tools in our toolbox, it's not gonna be a magic bullet or one size fits all. It's definitely not FMT, but it does have something in it that's a little bit different than traditional food or herbal or probiotic supplements. 'Cause it's just a complex mixture of stuff we couldn't really synthesize any other way.

Yeah. And how did you settle on the 100 milligram dose?

We tried high dosing originally. We tried to mimic FMT exactly and just autoclaved an FMT dose and it just didn't seem to do as much. I've had a couple really interesting conversations. So you think about FMT and the mechanism of what it is, is probably a combination of the bacteriophage, the viruses within our gut that infect other bacteria, bacterial engraftment, fungal, and postbiotics. And of all of those, postbiotics are gonna be working at a low and slow dosage as opposed to phage, which are a big strong punch short-term. And so what we found is after we autoclave and all that stuff is dead and all that's left are these small molecules, high doses don't seem to have any added benefit, but low doses over time do seem to shift stuff. And so we sort of tapered people down and saw where you could still get benefit, not really have any side effects, and then maintain dosing. And that's how we got there. I would love to do a proper controlled dosing study, but I think for us, somewhere between— we were at 50 milligrams for a long time, and then we increased it to 100 milligrams because of that trade-off of like would a little bit more help. Sometimes patients take 2 caps, but I've definitely taken 10 or 30 caps at a time and it just doesn't seem to do anything extra. And we tried that with patients in the early days and it didn't seem to do anything, so we moved away from that recommendation strategy.

Okay. Interesting. So I understand that you're sending me a bottle so I can give it a try. I'll have some time before I publish, so I'll be sure to include in my exit comments what happened and how it impacted me. So I'm excited to, to try that.

Yeah, I would say some of the interesting things we have observed is that it's very mild and generally the biggest concern people have is that it does nothing. We're working towards a money-back guarantee so you could try it for 30 days and if it doesn't do anything, you don't spend a bunch of money. But hopefully by the time this goes live, we'll have that set up. And then the small set of side effects people have reported, because we have an adverse event reporting, is people who have constipation. This can cause transient cramping as their gut starts to move, but it doesn't last very long. So it's like day 3 to 5, people will get an increase in motility and report cramping. And then we've had some people report like an increase of stomach acid, which was great in the context of turning that orchestra on, especially if you've had chronic IBS and dysregulated GI nervous system patterning. You know, I have patients that take tons of HCL and digestive enzymes, and if we could just get that turned back on organically and not have to take all that supplemental support with every meal, that's great. So that's actually giving us some hints towards what the mechanism might be. Motility and gastrin, and I have a lot of scientific research questions that someday I'll have money to answer.

Yeah. If only our system worked a little bit differently so that these new interesting things got research funding.

Maybe there's some of your listeners that are researchers that wanna do collaborations with us. We would love to do more academic collaborations. I will ship poo powder to anybody who wants to throw it on their in vitro models.

Awesome. And I will include a link in the show notes where you can get it. I signed up as a provider, so if you get it through my link, you'll be supporting the podcast. Any other things you wanna mention or places to go or links?

I'm happy to share. I mean, we are really trying to create a microbiome education system around this. In particular, if you're a provider, you sign up, we have tons of continuing education content. We are build the newsletters and the ecosystem type things that you do. And I'm happy to share my Twitter is where I bookmark all my microbiome studies, but I've always been really passionate about teaching about the microbiome and how our health and our decisions and the environment around us impact it. So I would love to hear from people and you can reach out to me through Twitter. It's @DrLindseyParsons. Dre, D-R-E Macbeth. My name's Andrea Macbeth. I'll send that to you too. I appreciate the time and the space. I love your podcast. When, like, when I started Googling podcast fecal transplant many years ago, it was always great to listen to your interviews cuz it's such a cool paradigm shift to be a part of, right?

I mean, those are some of the funnest ones because I mean, obviously FMT doesn't work for everybody, but for the people for whom it works, like it's miraculous what it can do. And I wish it were more accessible, but I'm pretty excited about your product and how that might be a substitute for FMT for people who are struggling.

Yeah.

And check out the rebiotics. The rebiota product is gonna be on the market, hopefully series therapeutics approved relatively soon. There's a company out of Australia that has a product approved in Europe. Called Biome Bank. So the tide has shifted. There are more of these out there. The US actually just approved a Phase 3 trial for a company out of France called MAAT, M-A-A-T, and they're an FMT company that works specifically with cancer patients going through bone marrow transplants. And it's amazing. Their data on this part of bone marrow transplants called graft-versus-host disease is really incredible. So I'm optimistic. The last 3 years have been crazy, but hopefully we'll start to see more and more tools for different people across different components of the spectrum.

Yeah, I'm excited for that too. Well, thank you so much for coming on and sharing about Theanabiotic.

Thank you so much.

Okay, so one quick clarification on accessing Theanabiotic. You don't need to have a relationship with me to access it. But if you are interested in using it, please email me at Lindsey Parsons with an E-Y at High Desert Health Coaching dot com, or set up a free breakthrough session through the link in the show notes. I promised a review of Thanabiotic in my exit, but I've only been taking it for a couple days, so all I can say so far, so good at this point. So I'll include a more thorough review in a future podcast once I've been on it for a whole month. If you'd like to support the podcast, you can buy supplements at a discount from my FullScript dispensary. Order tests at a discount from my Rupa Health Lab store, or use my affiliate links to eVitamins, Bulk Supplements, or Amazon. And if you'd 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 Twitter, Instagram, TikTok, and Pinterest. Links for all those are in the show notes. Thanks for joining me today, and here's wishing you all the perfect stool.