A case study of a fecal transplant for CFS

Fecal transplants to remove a single bad bacteria like Peptoclostridium difficile, more commonly known by it’s old name as Clostridium difficile have been very successful.  When it comes to a syndicate of bad bacteria which seems to be the case with myalgic encephalomyelitis/chronic fatigue syndrome, the story that I have heard time and time again from correspondants is simple:

  • Almost immediate remission
  • Remission disappears around 6 months.

Standard medical advice after a fecal matter transplant is usually “Do not take any probiotics” — I am in strong general agreement because people will usually try off the shelf probiotics. In the list below, the common off the shelf probiotics are on the avoid list – confirming this general advice for this person. There is evidence suggesting that very specific probiotics (not always easy to get) may be of significant benefit.

A reader share a before and after several month lab tests (after symptoms started to reappear). Unfortunately they were from different labs so it was not possible to do an easy side by side. Only two items were reported on both. One went from low to high, but the other was reported as very high on both:

Shigella/Escherichia

There are good and bad members of this group, and we should likely assume that there are robust bad ones that have made a comeback.

 

This becomes a challenge…. I suspect that normal Escherichia Coli (like Symbioflor-2) will likely be eliminated by these. Given the history of the very robust good Escherichia Coli Nissle 1917 (Mutaflor),   a trial for 1-2 weeks should be discussed.

Other Suggestions

We have a before and an after lab. The return of symptoms suggests that the prior syndicate of bacteria is returning.  Fortunately, on the Other Labs Analysis, we have

which allows me to enter both test results at the same time and get a list of suggestions.

There were several probiotics that were clean suggestions (i.e. no negative impact known on any shift):

There were also some clean avoid advice, do not take:

And several with far more harm than good being calculated, do not take

There are many which are very unclear if they will help more than hurt. I would generally advise against them unless there are no clean ones. The numbers are weighted by the number of studies — NOT the magnitude of effect (almost impossible to find those numbers for  most things)

uncertain

Prebiotics – AVOID!

Again for these specific results, the engine found no prebiotic was safe to take. This point may be missed by physicians…

prebiotic

Supplements

The following are clean suggestions — most of the B vitamins and melatonin

vitamin

But do not take:

Diet is usually a pain because they are massive collections of positive and negative foods (and spices).

Bottom Line

The above suggestions are based on a specific person’s results using two different lab reports. If you click thru on the linked items above, you  will be taken to the studies the suggestion was based on, for example for triphala impact on Escherichia.

trip

Prior Posts on FMT

Again, this is an education post only. All changes in probiotics, supplements and diet should be discussed with your knowledgeable medical professional before starting.