Adapted from episode 103 of The Perfect Stool podcast hosted by Lindsey Parsons, EdD, Gut Health Coach with Andrea McBeth, ND, Co-Founder of Thaena, and edited for readability.
Lindsey:
So why don’t we lead off with a description of what Thaenabiotic 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 some background and then finish up with the research and uses and such.
Andrea McBeth:
Sure. Thaenabiotic 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.
Lindsey:
And what is a postbiotic?
Andrea McBeth:
We’ve heard of probiotics–those are the live organisms that either are cultured in food, and we eat and they confer a health benefit. Sometimes we also think about the microbes in our gut and microbiome. The food that they eat are the prebiotics, which we have also started to hear about, so fiber, 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 gets converted through metabolism into small molecules that we’re now starting to look at and think about and call postbiotics.
Lindsey:
Right? So, for example, short chain fatty acids like butyrate?
Andrea McBeth:
Yes.
Lindsey:
Okay. So I think people have some familiarity with at least that because I have a butyrate supplement that was recently put on the market and have talked a lot about it in my podcasts. How do you screen your donors for Thaenabiotic? 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?
Andrea McBeth:
So we derived this from work we were doing in a fecal transplant stool bank setting. We both are doing all the infectious disease testing and whole genome sequencing and defining health through a series of history, 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?” we also consider, “what do you eat, what is your lifestyle, were you vaginally born and were you breastfed?” 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. 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 using 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.
Lindsey:
Okay. But specifically, are you checking to see if they have all the keystone species of a healthy microbiome, for example?
Andrea McBeth:
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. 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.
Lindsey:
And how often would you screen somebody for infectious diseases?
Andrea McBeth:
So we screen every six months, and we also have a 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.
Lindsey:
And are you getting pooled donations? Or are you getting a product that’s just coming from one person?
Andrea McBeth:
Yeah, so we have multiple donors, and what we’re doing is identifying within a certain sub-batch a group of their individual persons’ 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. We’re autoclaving as the first step, so everything is getting killed. But at the end, it is a mixture of multiple people’s metabolites.
Lindsey:
I’m not sure I understood exactly the distinction there. So you’re pooling a smaller group, and then you’re pooling it into a bigger group?
Andrea McBeth:
Were subclassifying it so that we can verify that we’re working within a single donor. Another part of this project is to start to understand the characteristics of metabolites that are coming from different people at different time points. So we’re collecting samples along the way, the end product is pooled between multiple donors and many, many stools.
Lindsey:
Okay, so are the dead bacteria gone too, or are the dead bacteria in there?
Andrea McBeth:
There are. It really is a prebiotic/parabiotic/postbiotic in its entirety, because it is whole stool that’s autoclaved. We do some processing to pull and save short chain fatty acids, but we’re not filtering everything out. The end product is a mixture of a little bit of everything.
Lindsey:
So it does have dead bacteria. And how do you pull out fecal material then from the mix? Or is it still in there?
Andrea McBeth:
Well, fecal material is a mixture of prebiotics and bacteria and dead cells and all that stuff.
Lindsey:
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?
Andrea McBeth:
So early on, we were like, well, is this going to do anything, right? Our idea was, what if we could pool 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. 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 mixture of thousands of these small molecules, and 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. To the best of our preclinical and clinical observation, it’s doing something related to small molecule nudging–of less so the short-chain fatty acids. There are 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.
Lindsey:
Well, 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.
Andrea McBeth:
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. My passion has always been chemistry and molecular biology. 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. I think that 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; it’s the canary in the coal mine of the environment we’re interfacing with. 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 and 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.
Lindsey:
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?
Andrea McBeth:
Well, we have been doing FMT for C. diff that was not responding to therapies for a long time. 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, 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. It’s not just that their diarrhea goes away– they feel better, they have less fatigue, and 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. So people would call us and ask us and we would have to say, “no, it’s not accessible.”
We work with nutrition in support of things all the time as functional gastroenterologists, and it was really a moment of “what if it’s not just the bacteria or phages or viruses?” Maybe there’s another component of compost in the 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, 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 the small molecules? And then COVID happened, and then we couldn’t provide FMT because we couldn’t screen for COVID. That was a really good reason to put the poop in the autoclave. And so that’s kind of how it started. From there, we’ve gone down this path of developing something that is safe, tested, food-derived and fits more into this classification of dietary supplement. So there’s another tool in the toolbox to modulate the microbiome in the same way that early probiotics were brought to the market.
Lindsey:
So when did it come on the market?
Andrea McBeth:
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.
Lindsey:
Okay. So I didn’t get a straight answer though, in the sense of, was there a conversation with the FDA about about wider stool transplant distribution, and did they reject the idea?
Andrea McBeth:
Well, I think I’ve been to most of the conferences and listened to FDA Q and A’s and had a couple off the record conversations and the clear articulation was infectious disease risk is a concern, and that makes logical sense. When I pitched things like, well, “what if we did autologous FMT?” 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 that component of concern in the infectious disease.
Lindsey:
Yeah, I think that whole situation in the US is very frustrating to a lot of people. I just went on the web and searched a little bit. There was a study, I think, of more than 5000 courses of FMT, in which there was a total of five deaths, and I think most of those could have been prevented if there have been proper donor screening.
Andrea McBeth:
I mean, I’ve always been fascinated with FMT. It works no matter who your donor is, so it can’t be this one magic bacteria. There’s got to be something about it that’s modulating the ecosystem. And I’m really excited about the Rebiotix product that’s out on the market, and we’ve shifted to using that clinically for C. diff, the approved by FMT enema they have.
Lindsey:
Oh, I’m not familiar with it.
Andrea McBeth:
Rebiotix is the first approved stool-derived FMT for C. diff. It’s on the market and insurances are starting to cover it; it’s huge that it’s now available. So we’re not going to do FMT anymore clinically for C diff. But Thaenabiotic is a bridge. It’s like the next generation in probiotics. It’s not fecal transplant, and I want to be really clear about that, but it came from that idea 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 and would that impact a recipient who has dysbiosis or doesn’t have those 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, that others, just because of the way they were born, their environment, their diet, or their antibiotic exposure, don’t have access to.
Right. So let’s talk about some of those postbiotics. So what are the different types of postbiotics that are found in Thaenabiotic?
Andrea McBeth:
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 are a good place to start. So short-chain fatty acids, as you mentioned, are a really good category, because butyrate is well characterized, and has a ton of benefits. It’s a really interesting molecule because it does things that provide energy, but it’s also an HDAC [histone deacetylase] inhibitor, right? So it changes the way that genes are read, there are good things about acetate, 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. 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, 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 in 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 post-biotics that are your favorite, but…
Lindsey:
Doesn’t everyone?
Andrea McBeth:
Yeah–ornithine and citrulline. I have a running list of my favorites that are in our product. Someday, I’m going to write a synopsis with my team.
Lindsey:
I think what you need is a one-a-day calendar, you know, you just tear off the page.
Andrea McBeth:
But I do think we have this treasure trove of small molecules that we’ve been coevolving 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, because the microbiome is kind of like a hormone organ that we just never saw and didn’t know what’s there. But feel free to keep me reined in, because I get really excited about the wonky chemistry. The big picture step away is that 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.
Lindsey:
Yeah, so where is Thaenabiotic meant to start dissolving? In the small intestine?
Andrea McBeth:
So, we put it in a capsule to get it enteric coated, but the powder, if you open the capsule up and take it orally, it still seems to work. 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 just a year ago. But now, there is evidence that bacterial drug 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 where these get delivered as long as they’re getting delivered to the GI tract. There is a component of the Thaenabiotic that is insoluble fiber and those prebiotics, but it’s a very small amount. So it’s not like taking a prebiotic supplement with like, 10 grams of ‘whatever’.
Lindsey:
Right, and you said it’s 100 milligrams worth of product. So just thinking comparatively, 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 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, that doesn’t make any sense with what you’re telling me because other than the short-chain fatty acids that may be feeding the lining of the large intestine, there, obviously, are other molecules that are being absorbed from the large intestine.
Andrea McBeth:
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–I like to think of the GI tract, mouth to anus as an orchestra–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 that digests and breaks things down, and then a component like the amino acids get absorbed in the small intestine. So in 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.
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 my studies. We know, thanks to the Weizmann Institute and fecal transplant studies they’ve done in Israel, that 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 contrary 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.
Lindsey:
So what kinds of conditions or symptoms are people trying Thaenabiotic for?
Andrea McBeth:
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 microbiome 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 access and all the evidence we have from fecal transplants and the role that probiotics and nutrition can play. We are very much at the beginning stages of working with physicians and functional medicine doctors to ask the question, “does your patient have a dysbiotic microbiome? And could they be missing some of this basic signaling because their ecosystem is depleted?” And if so, would this super-nutrient impact that? The general response is that, yes, it does seem to be a super multivitamin that can help 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, which, for example, is pretty well covered and at a high concentration, but that same idea applies to other lower concentration and really important molecules, like the indoles, or any of the amino acid derivatives and specialty bile acids.
Lindsey:
Yeah, I think that’s the follow up question that I was thinking of when you were talking about where absorption is happening. As you mentioned, l-citrulline is an amino acid, but I guess it’s not an essential amino acid. It’s derived from arginine.
Andrea McBeth:
This is where I apologize if it’s too much philosophy, but I come back to this concept of how 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 longer. 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, taking things from food and all that stuff–bacteria are doing the same thing. They are interacting with these molecules at all the different steps of the biochemical pathways that we traditionally think of as a human cell pathway. They’re breaking apart amino acids, adding things to them, changing bile acids and breaking apart fats. You’re ending up with this really complex milieu of intermediate molecules that, again, are similar to what we think of as traditional human biochemistry pathways, like the Krebs cycle and things like that. But that’s mitochondrial remnants of our bacterial cells themselves, so that is all happening on the bacterial level within the microbiome. It’s a sea of all these nutrients that are used for all kinds of things,
Lindsey:
Just in case people are having trouble absorbing what we’re actually talking about, I want to 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 were 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, and you’re not producing all those things. Maybe you’re producing some of those things because everybody still has some bacteria left, but you’re not producing all of them. And so now in one pill, you get a mixture of everything that a healthy person’s microbiome would be producing.
Andrea McBeth:
Yeah, we think about it like an ecosystem. So it’s the entire ecosystem instead of one or two culture 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. Instead of using a kombucha to ferment, you’re using a colon to ferment. They’re the same basic idea, it’s just that one is much more complex than the other.
Lindsey:
Yeah. So I know, obviously, you have to avoid the health claims, but I’m just wondering if there are any anecdotal stories from users or reviews…?
Andrea McBeth:
Unfortunately, not.
Lindsey:
Are the reviews up on the website, though?
Andrea McBeth:
I mean, we’re the only people autoclaving poops that are being really conscientious about this being something that is to support microbiome health. We have some really interesting data in longevity and longevity is not a health claim. So that’s really fun. We have a C. elegans model, which is a little worm that researchers use to study. There’s a bunch of genes that they have that we have, and there’s some analogy. So they’re a really nice model, because they’re easy to use, and they’re well characterized. 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 health spans 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 Thaenabiotic 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. This is a really potent antioxidant. That’s another framework for us to 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 was really excited. I didn’t expect to have data come back from the RNA sequence we did, which is a way of looking at the genes in the worms. When we gave them the antibiotic, 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, longevity and “inflamm-aging” if you want to make up a word that is thrown around a lot, that’s all related to oxidative stress and mitochondrial health. Again, with mitochondrial bacteria, whenever I hear longevity, people talk about mitochondria, just copy and paste that into microbiome. They’re the same thing.
Lindsey:
Do you have any clinical trials planned or underway?
Andrea McBeth:
We’ve got an IRB approval to work with these partner physicians in open black box observational pre/post testing and 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’s 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.
Lindsey:
There’s not a placebo in this case?
Andrea McBeth:
No. 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 proper pilot study. We have not yet, but we are very hopeful. Anecdotal data is what it is. It has some value, but it’s 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 sterilized poop 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 for whom it shifts stuff, it definitely makes a significant impact in the way that a dietary supplement that’s effectively utilized really can change people’s lives. So I’m cautiously optimistic, we’re going to keep learning.
Lindsey:
Yeah. So 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.
Andrea McBeth:
Yeah, 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. So it does seem to help just as a baseline, for me to take it every day as a supplement in the same way that I tried to eat vegetables, but I was born via C-section, I have chronic disease, so I’m like a whole host of things. Even though I’m not acutely ill, this seems to be a support. I think the cost-benefit 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.
Lindsey:
Thinking about the cost-benefit analysis and 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, is, of course, 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 Thaenabiotic 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?
Andrea McBeth:
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 six to nine 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 if you had diarrhea traveling. But it does seem to shift the microbiome enough or impact the neural immune 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, then try it a little bit longer. It’s in increments of 30 capsules per month dose, and then we have a 90 cap bottle that’s three months. So in general, after three to four 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 of food, you have more diversity in your microbiome, your immune system is less reactive, and 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 for benders or is it for prevention?” I said benders, and she said prevention at the same time. So it’s great if you want to 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. I think it just depends, again, on that cost-benefit and where people are at. It’s not something that you have to take indefinitely because 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; we’re reducing the leaky gut, histamine, etc., enough that you can then be maintained and at a better place. So when you think about functional medicine, your patients, my patients and our own IBS, you can get to a place where you’re good and then you plateau. Then you don’t have a tool, you’re doing everything right.
Lindsey:
But you’re still having diarrhea every month or week or so. Yeah, I’ve certainly heard that with a lot of people.
Andrea McBeth:
And then you try something like this that’s another tool that gets you to the next place. It gets you off that plateau, or it helps you be resilient to that next perturbation. Like all the other tools in our toolbox, it’s not going to 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. It’s just a complex mixture of stuff that we couldn’t really synthesize any other way.
Lindsey:
How did you settle on the 100 milligram dose?
Andrea McBeth:
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 about this. So you think about FMT, and its mechanism is probably a combination of the bacteriaphages, (the viruses within our gut that infect other bacteria), bacterial engraftment, fungal, and postbiotics. Of all of those, postbiotics are going to be working at a low and slow dosage, as opposed to phages, which are a big, strong punch short term. What we found is after we autoclave and all that stuff is dead, 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. So we 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, 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 two caps, but I’ve definitely taken 10 or 30 caps at a time, and it just doesn’t seem to do anything extra. 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.
Lindsey:
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. I’m excited to try that.
Andrea McBeth:
Yeah, I would say some of the interesting things we have observed is that it’s very mild. 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 there are a 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 three to five people will get an increase in motility and report cramping.
We’ve had some people report 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. I have patients that take tons of HCl and digestive enzymes. 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, with motility and gastrin. I have a lot of scientific research questions that someday I’ll have money to answer.
Lindsey:
Yeah, if only our system worked a little bit differently so that these new, interesting things got research funding.
Andrea McBeth:
Maybe there’s some of your listeners that are researchers that want to do collaborations with us. We would love to do more academic collaborations. I will ship poop powder to anybody who wants to throw it on their in-vitro models.
Lindsey:
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 by contacting me, you’ll be supporting the podcast. Are there any other things you want to mention or places to go or links?
Andrea McBeth:
I’m happy to share. We’re really trying to create a microbiome education system around this. In particular, if you’re a provider and you sign up, we have tons of continuing education content. We are building the newsletters and the ecosystem type things that you do. I’m happy to share my X, which is where I bookmark all my microbiome studies. But I’ve always been really passionate about teaching about the microbiome and how our health, 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 X. It’s @DreMcBeth, my name is Andrea Macbeth, I’ll send that to you too. I appreciate the time and the space! I love your podcast. Like when I started googling podcast/fecal transplant many years ago, it was always great to listen to your interviews because it’s such a cool paradigm shift to be a part of, right?
Lindsey:
I mean, those are some of the funnest ones because, obviously FMT doesn’t work for everybody, but for the people for whom it works, it’s miraculous in what it can do. 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.
Andrea McBeth:
Yeah, and check out Rebiotix, the REBYOTA product that is going to be on the market, hopefully Seres Therapeutics-approved relatively soon. There’s a company out of Australia that has a product approved in Europe called BiomeBank. So the tide has shifted. There are more of these out there. The US actually just approved a phase three trial for a company out of France called MaaT. 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 vs. Host disease is really incredible. So I’m optimistic–the last three years have been crazy, but hopefully we’ll start to see more and more tools for different people across different components of the spectrum.
Lindsey:
Yeah, I’m excited for that too. Well, thank you so much for coming on and sharing about Thaenabiotic. Thank you so much.
If you’re struggling with bloating, constipation, diarrhea, soft stool, acid reflux, IBS, IBD or any type of chronic disease, etc. and want to get to the bottom of it, that’s what I help my clients with. You’re welcome to set up a free, 30-minute breakthrough session with me (Lindsey). We’ll talk about what you’ve been going through and I’ll tell you about my 3- and 5- appointment health coaching programs in which I recommend lab tests, educate you on what the results mean and the protocols used by doctors to fix the problems revealed. Or if you’re ready to jump in right away or can just afford one appointment at a time, you can set up an 1-hour consultation with me.
