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Coming Soon: Gut Bacteria That Cure Disease (bloomberg.com)
184 points by HillaryBriss on June 30, 2016 | hide | past | favorite | 59 comments


I have a food intolerance based allergy/autoimmune issue which is under a broad headline of "Non IgE mediated autoimmune disorder".. manifestations are depression, fatigue, chronic skin issues (on my face :-().

I've been told the only "cure" is to abstain from eating about ~160 staple foods that contain proteins that my autoimmune system incorrectly recognises as something to attack, the problem is however you can barely get through a day without eating one of those staples unless you cook all your own food, and don't mind eating tuna, rice, chicken and (some) beans all the time.

I have a lot to look forward to from these treatments. I've had very good experiences with General Biotics' (SFO) product which claims to try and get the gut bacteria back in balance, I have no affiliation with them other than a dependence on their product if I want to be sane, happy and healthy in the short term..


Just be careful you haven't been scammed. I did an ALCAT test quite a few years ago, and they told me I was intolerant to a bunch of different foods. More research showed that the test is a load of bunk. Most of these "Non IgE mediated autoimmune disorder" tests are scammy pseudoscience.

From what I can tell, the most likely cause of depression and fatigue is stress/burnout.


I did an IgG food allergy test recently that I was extremely skeptical about in advance, but the results were consistent with my own observations over the past few years - namely that I was having severe reactions to some dairy. The tests showed exactly that as my issue. So I've eliminated dairy from my diet and I'm seeing what effect it has.

The general impression I got from my research is that some of these tests can be useful, but only when used in conjunction with other observations and case history. I do agree that some can be pretty scammy though - especially in their claims of the things they can fix. So like the parent poster, I'm really eager to see how these actual science-backed and FDA-approved solutions do for people too.

Also, stress and burnout are certainly a big factor in depression and fatigue, but these autoimmune problems are very real and can also have similar effects. I personally have a diagnosed autonomic nervous system disorder that apparently contributes to both the autoimmune and gut issues I deal with, as well as my severe fatigue and impaired mental state. I don't know that those areas - the gut, energy, and brain - are directly related on their own (the doctor I'm working with thinks they are), but I'm happy to try anything that might help any of them, and see what happens.


Just bear in mind that autonomic dysfunction happens in everyone after acute stress, and it is common in chronic fatigue syndrome [1]. It looks like autonomic dysfunction is perhaps just a symptom of fatigue (or, it is caused by the same part of the brain that generates the sensation of fatigue).

I'm not aware of any research showing that dairy intolerance can cause fatigue and depression. There is some stuff about casein acting like dopamine, but it seems to be pseudoscience.

We do know that stress definitely causes gut issues (changes in motility, absorption, and bacteria). Whether there is any causality in the other direction (apart from when you have an active infection), however, isn't really clear.

It can be difficult to definitively figure out whether or not you are actually intolerant to something. I thought for a while that I was intolerant to potatoes, but further research shows that I'm not. (Right now I eat them regularly and have zero problems). If you're interested in really figuring out whether dairy is causing you problems, try introducing small amounts of dairy when you're feeling great and see if anything changes. (Just make sure you're not lactose intolerant before doing that!)

[1] http://www.ncbi.nlm.nih.gov/pubmed/26420687


Right, you've described my current plan - to eliminate it entirely for a while to see what happens, then slowly reintroduce things to see if I get any reactions. Besides the IgG test some of my own observations were acute reactions in my mouth from certain cheeses, and things like that - so I'm certain there's some kind of allergic reaction to... something going on. (The test I took specifically did show that casein was the problem in my case. We'll see.)

And agreed that stress can cause those issues with the gut - and for me at a minimum exacerbates other things already going on - but yeah, I'm seeing and hearing a lot about how it goes the other way but I'm not seeing the science or experiencing it yet in my case.

Also - in my situation the autonomic dysfunction has a strong biological component. I have postural tachycardia and peripheral neuropathy caused by a genetic collagen issue (Ehlers-Danlos), so I know that there are major physiological factors going on and contributing to all my various issues. And then stress - which is aggravated in my case by wildly fluctuating heart rate - compounds all of that, creating a whole vicious cycle of impairment. Unraveling this whole web and picking away at parts of it at a time is my current challenge. But I am pretty confident that while depression contributes in some ways to my fatigue, it's also majorly impacted by my heart rate and probably some adrenaline issues common in Ehlers-Danlos.

(I appreciate this discussion and your thoughts, by the way.)


>I'm seeing and hearing a lot about how it goes the other way

Well, you need to be careful who you listen to. There are an infinite number of dubious naturopaths (and many MDs) who buy into dubious theories and spread them. There are a lot fewer people who will tell you "stress causes burnout, which causes POTS, ANS dysfunction, depression, chronic fatigue/pain, digestive problems, etc.", even though this is based on a more correct understanding of how the body works. The USA seems particularly bad for MDs believing dubious theories, for a number of reasons.

> acute reactions in my mouth from certain cheeses, and things like that - so I'm certain there's some kind of allergic reaction

If it is an allergic reaction, it will show up on an IgE. Bear in mind, though, that some cheeses are just sharp.

>Also - in my situation the autonomic dysfunction has a strong biological component. I have postural tachycardia

The autonomic nervous system is biological/physiological, but is modulated by stress. It doesn't really make sense to separate these systems into "biological" or "psychological".

Postural tachycardia and depressed parasympathetic nervous system are typical symptoms of CFS caused by burnout from stress. I had these symptoms myself, very severely (I had periods where my digestive system didn't move at all, and where I had atrial fibrillation due to the tacycardia). However I've recovered completely from it now and have no symptoms.

>caused by a genetic collagen issue (Ehlers-Danlos)

Did you suffer from these symptoms your whole life? If not, I'm not sure how it fits. Typically CFS comes on suddenly and/or you have relapses and normal periods...if that's how your illness manifests then I don't see how a genetic collagen could explain it. Also, allergies are a different issue to a genetic collagen problem (and neither really explains depression). I have a moderately severe allergy (hay fever), but zero depression or fatigue from it.


I have a friend with a similar problem, and she eats a lot of fish as a result. She recently found out she has a very high mercury level. Be careful if you eat a lot of tuna. She switched to chicken. I wish more research was being done on problems like you and my friend have.


Is she eating only huge fish? Small fish selenium > mercury, which bind to each other and are not absorbed.


Actually, she was high on more than just mercury, so probably she was high on selenium, too. She had to go through some expensive treatment with many side effects. Nasty stuff.


That's very interesting. What kinds of time periods and amounts of fish do we speak of here? Years and eating a fish meal every couple of days? Because I love fish (also a lean source of protein) so I better be careful with that. How did she find out? Was she unwell and went to a doctor to get blood work done?


There's been a lot of hugely promising work in the field of using symbotic bacteria to regulate gut immune responses. In one case [1,2], a strain of hookworm were used to treat coeliacs for their gluten intolerance with incredible effectiveness.

The theory is that hookwrom have developed a protein that they secrete to suppress the intestinal immune response so that they can inhabit the intestinal tract without being attacked. This same protein also happens to treat the overreaction that causes gluten intolerance. Present work is aiming to isolate the protein and produce it in pill form. The tip-off to this was that instances of dietary intolerance and immune response issues (asthma, allergies, etc.) are dramatically lower in the developing world, and that maybe some aspect of their relatively unclean environment plays a role in regulating the body from overreacting.

It's being increasingly shown that the intestinal system as a dynamic and complex system of bateria plays a significant role in many aspects of human health, not just the digestion of food. We're only just starting to scratch the surface of this. Expect massive development in the coming couple of decades.

[1]: http://www.abc.net.au/news/2015-11-10/hookworm-larvae-inject...

[2]: https://research.jcu.edu.au/bmdt/publications/publications-1...


You are probably being bombarded with suggestions, and am overwhelmed, so it's probably not very useful to add yet another one, but ....

Reducing carbohydrates significantly (as happens in keto and even paleo diets) anecdotally seems to make autoimmune disease and allergy quiet down significantly. I am not aware of any studies confirming this, but the anecdotal evidence in /r/keto and people I know seem to be overwhelming. It's also "cheap" to try in money terms (although the commitment and change are sometimes emotionally expensive).

If you go keto, be sure to read about changes to electrolyte needs and how to avoid feeling bad (short story: you need more salt in your diet in the first few days of keto, or you'll get something called "keto flu").


How do they diagnose this condition?


I have a condition called GERD and it was recently discovered that it's caused by the bodies reaction to a protein: http://jama.jamanetwork.com/mobile/article.aspx?articleid=25...

This research will likely change my life for the better.


I remember the last General Biotics submission here on HN, and I though their product sounded interesting. (https://news.ycombinator.com/item?id=8456128) But I was waiting for their results on their large randomized trial to be published, which have since been delayed by quite a bit ...


I've been taking them for a few months with good personal results in terms of digestive function and minor weight loss.


I have a related issue with similar manifestations that also affects my eyes and joints.

For anyone interested, Cyrex Labs[0] offers several immunology tests relevant to this discussion.

[0] https://www.cyrexlabs.com/CyrexTestsArrays/tabid/136/Default...


I had a friend with similar issues, I think she called it a hyperpermeable colon. She tried all sorts of diets and after a couple years she slowly regained the ability to eat more and more foods.


> hyperpermeable colon

Sounds like a fancy word for the fanciful "leaky gut syndrome".


Leaky gut is not a real diagnosis, and is mixed up with a lot of quackery and pseudoscience.

https://en.wikipedia.org/wiki/Leaky_gut_syndrome

Not sure why you were downvoted.


So-called “leaky gut syndrome” is legit, and likely plays a role in food allergies, type-1 diabetes, Celiac disease, Crohn’s disease, irritable bowel syndrome and other digestion-related maladies, Fasano says. But at the same time, he says the term “leaky gut” has for decades been “used and abused” by some alternative medicine practitioners who—without scientific evidence—cited it as the cause of everything from autism to cancer.

As a result, “the scientific community vilified the idea of leaky gut,” Fasano says. Despite the growing body of evidence, many medical practitioners are still coming to grips with the fact that leaky gut is a legitimate contributor to some ailments.

The science is constantly evolving: http://time.com/4178015/leaky-gut-syndrome-probiotics/


That's a Time article...the scientific consensus says otherwise. Also notice how he says "likely". I think that is perhaps being over optimistic.


> don't mind eating tuna, rice, chicken and (some) beans all the time

Is this some kind of allergy to red meat? I'm curious if it is bovine, porcine, or oviod related?


Isn't it ovis or ovum?


Think I meant ovine, i.e. sheepish


Celtic sea salt and coconut oil also do good things for the gut. Your gut is about 70 percent of your immune system. So, getting it more functional can do good things for all kinds of problems.


A microbiome treatment for C. diff (which is what the article mainly focuses on) seems eminently plausible, and an effective treatment can't come soon enough. However, for a lot of the other diseases that the title hints at (and are mentioned in only one paragraph in the article), there's just not that much reason to be hopeful. We have a pretty good handle on what causes cancer, and while you can tell a story about gut->immune system->{cancer, liver disease, OCD}, there's just a lot more places for things to not work.

[1] has a great summary of the current state of research on the microbiome-health connection: "We still don’t really understand what these microbes are doing, so we can’t infer what their absence or presence implies."

[1]http://www.theatlantic.com/science/archive/2016/06/the-plot-...


Mark my words: There will be two new types of "banks" : youthful post puberty blood bank of 15-25yrs old and banks for same age group of fecal deposits. There is nothing like a body at the peak of performance and function. Best case, you would be encouraged to save your own blood and fecal matter for your later years. Worse case, you'll have to buy both. Oh my goodness though... you can actually make $$ from selling your.... but I think it will happen. I believe this is just the beginning of how/what gut bacteria actually does for your body. Ever wonder why something like prozac causes constipation when all it's supposed to do is increase serotonin levels in your brain? Just a brain fart..thinking out loud.


At the moment blood isn't cheap or easy to preserve. Then there is a matter of supply. Current research involving parabiosis in mice required a significant age difference and a continuous supply. Meaning you spend 15 - 25 trying to produce double the amount of blood just so you have what you need when you are 70 to 80. Transgenic xeno blood is a more likely solution if not synthetic blood or protein filtering.

Regarding self fecal implants, the case where it could be most beneficial is in post antibiotic treatment. I recall seeing a a before/after graph of gut flora. Antibiotics had the effect of a nuclear bomb. Even years later, gut flora was still a fraction of what it had been.


Hi louprado. yes, I understand about blood life but I'm thinking the bank "purchaseable" blood will be a busy cycle so no worry about needing to store long term. however, to my point about long term storage you're right for now.

And as for the fecal "transplant", I think we are at an infancy in understanding. Our gut is so central to our very survival that I'm dumbfounded we haven't discovered this sooner.

I think from food allergies to Ulcerative Colitis to your emotional state to maybe even cancer, any ailment of your entire body OR mind will have a direct link to gut bacteria. I'm sure of it.

No doubt that it does sounds absurd to think that a group bacteria can dictate how well your body AND mind functions, but that's what I'm saying...


This is true. A big course of broad-spectrum antibiotics creates an... unpleasant response. They really do nuke the biodiversity of the gut and it takes a while to strike a balance back.

Here's a good wired feature done a few years ago on the topic: http://www.wired.com/2011/09/mf_microbiome/


According to Art Ayers, a lot of common medicines have antibiotic properties:

Most pharmaceuticals are derived from phytochemicals, a.k.a antioxidants, adapted in plants to kill microorganisms, i.e. as natural antibiotics. It is not surprising that drugs = antibiotics. What is surprising is that people assume that if antibiotics are labeled with some other activity, that they cease to be antibiotics. All drugs are also antibiotics and that is why a major side effect of most medicines is upset gut bacteria.

http://coolinginflammation.blogspot.com/2015/08/common-medic...


From Wikipedia:

Approximately 90% of the human body's total serotonin is located in the enterochromaffin cells in the GI tract, where it is used to regulate intestinal movements.

My experience with SSRIs is that I feel a difference in my gut before a mood difference.


Another reason why someone who has ulcerative colitis / crohn's could get some benefit by using a drug specifically to target brain function like SSRI type drugs. I think brain chemistry altering drug could assist in autoimmune type diseases.


> “Patients have different preferences,” Hecht observes, but “in general, people don’t particularly like enemas.”

This is probably the best argument against a competitor's product that I have heard.


From what I understand, getting these treatments through the FDA was rather tricky. This paves the way for future treatments.

The money quote:

The company has built a microbiome library of 14,000 strains of human bacteria it hopes will help it treat a range of diseases, eventually without needing feces at all.


Another unique properties accidentally being discovered from FMT aka fecal implanting is the recipients seems to inherent the donor's properties like being obese to having affinity to certain types of foods. Soon we may discover that if we want muscle growth, we simply get FMT from a bodybuilder or if you want more efficient metabolism you get FMT from an endurance runner. Additionally, you may be able to over come any food allergies like peanuts by getting a FMT from someone who isn't allergic.

I think the possibilities of this yet to be understood cure all of gut bacteria is just beginning.

This could be a GREAT disruptive game in the medical field. Wanna startup? :)


However, please be cautious, there are lot of things that are left to be desired out there. I recently read about their use in stroke patients for example. Lots of things about the microbiota is simply wishful thinking.

http://www.ncbi.nlm.nih.gov/pubmed/26945017


'He's not an 'acceptable person' -- he's like an armed warhead! You wondered about drug factories -- Sticky Thompson is a drug factory."

"What's that supposed to mean?" Laura said.

"I mean his guts are full of bacteria. Special ones -- little drug factories. Where do you think he got that nickname -- Sticky? He can eat a carton of yogurt and it turns him into a killing machine."

"A killing machine?" Laura said. "A carton of yogurt?"

"It's the enzymes. The bugs eat'em. Make him fast -- strong -- feeling no pain, no doubt at all. They're gonna sic him on ... and wow, I feel sorry for that little ..."'

-- Islands in the Net, Bruce Sterling, 1988


It's tempting to say that some proof is not there yet, but considering the amount of studies published every year and inability to read even abstracts of all of them it's often far fetched. It was shown more than once that certain gut bacteria cure certain kinds of allergies: http://evidenceba.se/answers/17-allergies-can-be-treated-wit...


It takes far too long to get a fecal transplant for c. diff, especially when it has a proven success rate of about 92%, compared to 50-80% for the antibiotics. This is a big deal.


The OP mentions OpenBiome which is the worlds first independent stool bank and supplies feces for transplants. They have a 3% acceptance rate for donors and select only the healthiest individuals.

It would interesting to see how their screening process evolves given the plausibility of all the health affects beyond the GI system of fecal transplants. For example, it may be that mental health wasn't screened beyond a cursory exam but later it could be a significant part of screening.

But if they are already reject 97% of donors and the demand is increasing, the economics encourages lowering the screening bar, not raising it.


News like this, and CRISPR, and pending patents on genes, seems eerily similar to the prelude to Gene Wars...

http://www.lightspeedmagazine.com/fiction/gene-wars/


So you can use yogurt to deliver medicine rather than a pill.

After reading the article this seems to be a piece paid for Seres Therapeutics in order to raise their stock price.


Gut bacteria from thin people can help lose weight?


Not sure how much gut bacteria will help with weight loss, but it does seem to go the other way.

One of my favorite papers in the field in the last couple years shows a potential causal relationship between obesity and gut biomes by using artificial sweetener and a fecal transplant in mice.

Paywalled version in nature: http://www.nature.com/nature/journal/vaop/ncurrent/full/natu...

Unpaywalled version after googling: http://www.drperlmutter.com/wp-content/uploads/2014/09/Artif...


I believe it absolutely can. It has gone the other way where someone got FMT from an obese person and they needed up obese themselves! makes perfect sense since the gut bacteria is the actual digester of your meals. They will determine how to digest the various fat/protein/carb/sugar you eat. So people with say.. thyroid problem who typically gain weight out of their control probably stems from gut bac imbalance I'm conjecturing because believe or not the gut bac also has a say in productions of hormone from all your glands. I would bet those individuals if gotten FMT from a healthy donor would reverse that course.


Vice on HBO recently (June 24/2016) did an interesting segment on this subject.


Am I the only person that remains skeptical about these claims?


Well... that will cure your C. Diff.


C. diff. is just the disease first in line. Chronic fatigue syndrome may be lining up behind it: https://www.washingtonpost.com/news/to-your-health/wp/2016/0...


> First, the indicators could be used in the future to help diagnose the condition, as they were present in 83 percent of the patients with chronic fatigue syndrome. Second, it suggests that diet and things like probiotics may be a way to help treat the disease by getting the gut microbiome back in balance.

This kind of reporting bugs me. They might have found a possible correlation here, that's all. Yes, that first item is a possibility because the correlated indicators could be used to detect conditions related to CFS, but the second item is pure speculation about cause and effect, and is jumping to conclusions about it pertaining to treatment.

Personal anecdotal insight - I have a genetic condition that affects both my gastrointestinal system and causes chronic fatigue-like symptoms. I'm treating both separately but because there's an underlying condition affecting both independently (probably), it doesn't mean that treating one will improve the other. It's a longshot possibility, but saying "may be a way to help treat the disease" is just interpretation and overly-optimistic hype.

The indicators they found do sound really interesting though. If validated it would be an amazing benefit to patients just to confirm that there's a biological factor to these conditions.



Hopefully, but there need to be some pretty extensive human trials first.



At MGH! Well, they could get some good results either way, and quickly.


Not cool... Bloomberg is telling me I am using an additional blocker and literally have no extensions installed.


We block one or two ad networks on our local network because of spyware payloads and we get these boxes too from time to time. So, it might be upstream of you.


I feel that given trials, regulatory approval, and all the other obstacles facing new drugs (briefly referenced in the article), "Coming Soon" is the height of hyperbole.




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