Some people respond well to probiotic therapy, while others do not. This simple fact led to our development of the 8R gut program.** It is a comprehensive approach to enhancing ALL aspects of digestion. Importantly, it usually provides answers when a given therapy/intervention fails to improve an individual's health.
Here is a flow diagram for the 8R program.
I obtain feeds from Novel Biome, and they recently posted the following article.
"How a Recipient’s Gut Can Make or Break an FMT"
There are some important teachings embedded in the article that I believe the 8R program addresses.
Here is the content of the article.
For years, Fecal Microbiota Transplantation (FMT) has been all about the donor. The idea was simple: find the healthy donor with a perfect microbiome, and success would naturally follow. But what if the real key to FMT isn’t only the donor at all? What if the recipient’s gut plays an even bigger role?
New research is turning this long-held belief of donor importance upside down, revealing that the recipient’s microbiome and how it’s prepared might be the most critical factor in FMT success. This shift in perspective is changing how we approach gut health.
Here’s what you need to know.
A new study published in Nature Medicine has shaken the FMT world. It reveals that the recipient’s microbiome, not just the donor’s, plays the leading role in determining the success of FMT.
Think of your gut as a garden. If the soil (your microbiome) isn’t ready, even the best seeds (donor microbes) won’t grow. The study shows that the health, diversity, and even the specific microbial “gatekeepers” in the recipient’s gut decide how well donor microbes can take root and thrive.
LEWIS COMMENT: This applies equally well to probiotic therapy administered orally OR rectally.
Here’s where the story gets interesting. Before planting anything, you prep the soil. You remove weeds, loosen the dirt, and add nutrients. For FMT, this process is called pre-treatment—and it’s a game-changer.
Pre-treatment, often done with antibiotics, clears the recipient’s gut of competing microbes, making space for donor microbes to flourish. This isn’t just theory: the study showed that patients with recurrent Clostridioides difficile infections (rCDI) who underwent pre-treatment had the highest FMT success rates.
But there’s a catch: many other conditions treated with FMT, like autism spectrum disorder (ASD), don’t always include pre-treatment. And the results speak volumes:
In one study where pre-treatment wasn’t used, improvements in ASD symptoms were reduced. Compare that to research with pre-treatment protocols, which reported huge leaps in GI health and behavior.
The takeaway? The better you prepare, the better the outcomes.
What This Means for FMT Treatments
This new understanding reshapes how we approach FMT:
Focus on the Recipient: A well-prepped microbiome is critical to success.
Make Pre-Treatment Standard: Antibiotics or other gut-clearing steps (i.e. bowel cleanse) pave the way for donor microbiota to thrive.
Matchmaking Matters: Careful donor-recipient matching can optimize results, and the science is coming.
LEWIS COMMENT: Antibiotics don't necessarily mean pharmaceuticals. However, in severe cases of refractory guts, this may well be necessary. Step 2 of the 8R program provides a comprehensive list of natural antibiotics for the gut. I also recommend that people working to "reset" their gut take probiotics - as beneficial organisms have been shown to participate in the reduction of antagonistic microorganisms. A notable case is using saccharomyces boulardii to reduce candida(s).
References: 1. Askarova, S. et al. 2020, 2. Badal, V. D. et al. 2020, 3. Bana, B. & Cabreiro, F. 2019, 4. Buford, T. W. 2020, 5. Cryan, J. F. et al. 2019, 6. Li, H., Ni, J. & Qing, H. 2021, 7. Nagpal, R. et al. 2018, 8. O’Toole, P. W. & Jeffery, I. B. 2015, 9. Salazar, N. et al. 2017, 10. Bosco, N. & Noti, M. 2021, 11. Collino, S. et al. 2013, 12. Hohman, L. S. & Osborne, L. C. 2022, 13. Luan, Z. et al. 2020, 14. Wu, L. et al. 2019, 15. Choi, H. H. & Cho, Y.-S. 2016, 16. Gupta, S. et al. 2021, 17. Ser, H.-L. et al. 2021, 18. Xu, M.-Q. 2015, 19. Allegretti, J. R. et al. 2019, 20. Basson, A. R. et al. 2020, 21. Brandt, L. J. & Aroniadis, O. C. 2013, 22. Khan, M. Y. et al. 2018, 23. Moayyedi, P. et al. 2017, 24. Quraishi, M. N. et al. 2017, 25. Rinott, E. et al. 2021, 26. Park, S.-H. et al. 2022, 27. Bárcena, C. et al. 2019, 28. Haifer, C. et al. 2020, 29. Kong, F. et al. 2019, 30. Smith, P. et al. 2017, 31. Parker, A. et al. 2022.
** The 8R program is only available to clients of HRP.
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