TNT
Frequent Contributor (1K+ posts)
Member # 42349
posted
Rapid and unexpected weight gain after fecal transplant
Date: February 4, 2015
Source: Infectious Diseases Society of America
Summary:
A woman successfully treated for a recurrent Clostridium difficile infection with stool from an overweight donor rapidly gained weight herself afterwards, becoming obese, according to a case report.
------------------------------------------
A woman successfully treated for a recurrent Clostridium difficile infection with stool from an overweight donor rapidly gained weight herself afterwards, becoming obese, according to a case report published in the new journal Open Forum Infectious Diseases.
Fecal microbiota transplant (FMT) is a promising treatment for relapsing C. difficile infections, a common cause of antibiotic-related diarrhea that in severe cases may be life-threatening. The case suggests that clinicians should avoid selecting stool donors who are overweight. The report also raises questions about the role of gut bacteria in metabolism and health.
At the time of the woman's fecal transplant in 2011, her weight was stable at 136 pounds, and her Body Mass Index (BMI) was 26. Then 32 years old, she had always been of normal weight.
The transplant used donor stool from the woman's overweight but otherwise healthy teenage daughter, administered via colonoscopy, to restore a healthy balance of bacteria in the woman's gut, curing her C. difficile infection.
Sixteen months later, the woman weighed 170 pounds, and her BMI was 33, meeting medical criteria for obesity. The weight gain persisted despite a medically supervised liquid protein diet and exercise program. Continuing efforts to diet and exercise did not lower her weight:
Three years after the transplant, she weighed 177 pounds with a BMI of 34.5, and she remains obese today.
"We're questioning whether there was something in the fecal transplant, whether some of those 'good' bacteria we transferred may have had an impact on her metabolism in a negative way," said Colleen R. Kelly, MD, of the Warren Alpert Medical School of Brown University, who wrote the case report with Neha Alang, MD, of Newport Hospital in Rhode Island.
Such a link between bacteria in the gastrointestinal tract and weight is supported by previously published animal studies, where transfer of gut bacteria from obese to normal-weight mice can lead to a marked increase in fat.
In light of the case and the animal data, the authors recommend selecting stool donors who are not overweight for fecal transplants.
Importantly, the FMT was not the only possible cause of the woman's weight gain. In addition to treatment for C. difficile, she had also been treated with several antibiotics for Helicobacter pylori infection.
Other possible contributing factors in the woman's weight gain include the resolution of her C. difficile infection, genetic factors, aging, and stress related to illness. However, as noted above, she had never been overweight before.
The case raises many questions about donor selection and highlights the importance of studying long-term outcomes of FMT, according to Ana A. Weil, MD, and Elizabeth L. Hohmann, MD, both of Massachusetts General Hospital, who wrote a related editorial.
"Careful study of FMT will advance knowledge about safe manipulation of the gut microbiota," they wrote. "Ultimately, of course, it is hoped that FMT studies will lead to identification of defined mixtures of beneficial bacteria that can be cultured, manufactured, and administered to improve human health."
Fast Facts
Fecal transplants are a promising approach for treating recurrent C. difficile infections, a common cause of potentially life-threatening diarrhea.
In this case report, a woman successfully treated for a relapsing C. difficile infection with a fecal transplant rapidly became overweight for the first time in her life. The stool donor, the woman's daughter, was overweight.
The report suggests that donor screening for these transplants should exclude those who are overweight.
Story Source:
The above story is based on materials provided by Infectious Diseases Society of America. Note: Materials may be edited for content and length.
Journal References:
N. Alang, C. R. Kelly. Weight Gain After Fecal Microbiota Transplantation. Open Forum Infectious Diseases, 2015; DOI: 10.1093/ofid/ofv004
Ana A. Weil, and Elizabeth L. Hohmann. Fecal Microbiota Transplant: Benefits and Risks. Open Forum Infectious Diseases,, 2015 DOI: 10.1093/ofid/ofv005
Cite This Page: MLA APA Chicago
Infectious Diseases Society of America. "Rapid and unexpected weight gain after fecal transplant." ScienceDaily. ScienceDaily, 4 February 2015.
<www.sciencedaily.com/releases/2015/02/150204125810.htm>.
Posts: 1308 | From Eastern USA | Registered: Oct 2013
| IP: Logged |
Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
- Thanks so much for this article. It's important in so many ways beyond even the obvious, I just know it. -
Posts: 48021 | From Tree House | Registered: Jul 2007
| IP: Logged |
posted
I read something the other day about the different microbes affecting our weight.
Now I can't find it.
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96222 | From Texas | Registered: Feb 2001
| IP: Logged |
lpkayak
Honored Contributor (10K+ posts)
Member # 5230
posted
Sad for the woman but if it helps ppl who do a lot of what is healthy and still are obese good can come of it
-------------------- Lyme? Its complicated. Educate yourself. Posts: 13712 | From new england | Registered: Feb 2004
| IP: Logged |
lpkayak
Honored Contributor (10K+ posts)
Member # 5230
posted
Why is it that fecal implant works when high dose probiotics dont?
-------------------- Lyme? Its complicated. Educate yourself. Posts: 13712 | From new england | Registered: Feb 2004
| IP: Logged |
TF
Frequent Contributor (5K+ posts)
Member # 14183
posted
C. diff is never overcome by probiotics. In my case, antibiotics given for a sufficiently long time, plus Florastor did the trick.
But, antibiotics (vancomycin) don't always work. C. diff is extremely difficult to eradicate when it takes over the intestines. That's why it was given the name "difficile." It can kill people.
Probiotics don't eradicate anything. They are just the good bacteria.
For example, probiotics can't even eradicate yeast. That takes diflucan.
Probiotics are just a preventative. If you keep putting in the good bacteria, it makes it a little harder for the bad to take over.
Posts: 9931 | From Maryland | Registered: Dec 2007
| IP: Logged |
-------------------- The fibromyalgia I've had for 32 years was an undiagnosed Lyme symptom.
"For I know the plans I have for you", declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future". -Jeremiah 29:11 Posts: 6076 | From Pennsylvania, USA | Registered: Nov 2008
| IP: Logged |
lpkayak
Honored Contributor (10K+ posts)
Member # 5230
posted
Interesting. Have they figured out how to control the amount of each? Diet, med, supp...something else?
-------------------- Lyme? Its complicated. Educate yourself. Posts: 13712 | From new england | Registered: Feb 2004
| IP: Logged |
Dekrator48
Frequent Contributor (5K+ posts)
Member # 18239
-------------------- The fibromyalgia I've had for 32 years was an undiagnosed Lyme symptom.
"For I know the plans I have for you", declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future". -Jeremiah 29:11 Posts: 6076 | From Pennsylvania, USA | Registered: Nov 2008
| IP: Logged |
quote:Originally posted by Dekrator48: The transplant microbiota may have contained a greater proportion of Firmicutes vs Bacteroidetes leading to obesity.
This was discussed during the Healthy Gut Summit last week.
This obesity connection has actually been disproven in subsequent studies. It is now thought by most researchers that having a large majority of firmicutes is preferable to bacteroidetes. There are two clusters of clostridia, Lachnospiraceae and Ruminococcaceae, which are responsible for making butyrate from fiber, and which have a high correlation with gut health -- these are firmicutes. Whereas, bacteroidetes are associated lower gut fermentation.
Jeff Leach, who is studying the gut flora of Hadza hunter-gathers in Africa, has discovered that firmicutes dominate their gut flora population. And these are the people who we evolved from -- still eating the same plants and animals for hundreds of thousands of years, the diet our species evolved on. They are all consistently lean, slim, muscular, and weight stable, regardless of the seasonal shifts in calorie intake, fat intake, or sugar intake.
This blog entry explains much of this stuff about firmicutes and bacteroidetes in a very easy to understand way.
There are several science blogs that are about gut health, flora, immunity, etc., that take the current research and try to make sense of it. If anyone is interested I can post a couple of links.
Posts: 845 | From Eastern USA | Registered: Jul 2006
| IP: Logged |
lpkayak
Honored Contributor (10K+ posts)
Member # 5230
posted
Im interested
-------------------- Lyme? Its complicated. Educate yourself. Posts: 13712 | From new england | Registered: Feb 2004
| IP: Logged |
Dekrator48
Frequent Contributor (5K+ posts)
Member # 18239
posted
There were a number of functional medicine practitioners who mentioned that a greater number of Firmicutes vs Bacteroidetes can cause obesity, during their presentations during the Healthy Gut Summit.
I have not had time to read that blog yet, but none of those practitioners said that it had been disproven.
I sure don't think it is THE cause of obesity.
People eat way too much sugar, HFCS, grains, and unhealthy fats.
-------------------- The fibromyalgia I've had for 32 years was an undiagnosed Lyme symptom.
"For I know the plans I have for you", declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future". -Jeremiah 29:11 Posts: 6076 | From Pennsylvania, USA | Registered: Nov 2008
| IP: Logged |
2roads
Frequent Contributor (1K+ posts)
Member # 4409
posted
How can we alter gut flora to improve sleep, among other things? Hmm. Confused.
Posts: 2214 | From West Chester, PA | Registered: Aug 2003
| IP: Logged |
posted
I guess mainly we need to get rid of any "bad" bacteria. If we have a balanced gut we should sleep like babies!
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96222 | From Texas | Registered: Feb 2001
| IP: Logged |
2roads
Frequent Contributor (1K+ posts)
Member # 4409
posted
So how do we do that Tutu? Being thick here. Probiotics not the answer necessarily, but diet. So what to eat? Colored vegis, fiber?
Posts: 2214 | From West Chester, PA | Registered: Aug 2003
| IP: Logged |
Dekrator48
Frequent Contributor (5K+ posts)
Member # 18239
posted
In my notes from the talk, "Benefits of Non-Pharmaceuticals and Natural Cleansing" by Datis Kharrazian, DC,MS,PhD, he said that a plant based diet helps switch the ratios of firmicutes to bacteroidetes, but that it usually takes at least 3 months.
-------------------- The fibromyalgia I've had for 32 years was an undiagnosed Lyme symptom.
"For I know the plans I have for you", declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future". -Jeremiah 29:11 Posts: 6076 | From Pennsylvania, USA | Registered: Nov 2008
| IP: Logged |
posted
Sorry I have not gotten back here sooner, but I was hit by a nasty flare and everything has been put on hold.
I don't profess to be an expert, but I've been studying this gut stuff for the last year and have learned a good bit. My own gut is a severe mess, and, after much study, I have come to believe that much of the ongoing problems we attribute to Lyme and co's, may, in fact, be caused by gut bugs, particularly for those of us who have had years and years of extensive abx (or herbal) therapy.
Here are some blogs where they are discussing this. There are tons out there, but the ones posted here are all pretty basic and easy to understand. Oftentimes, the discussions in the comments sections are more revealing than the posts.
This first one is Jeff Leach's blog. He is the researcher doing the work in Africa with the Hadza, hunter-gather tribe. Also, he is the one doing the American Gut project. His blog entries are very informative and VERY well written. He is trying to understand the connection between modern disease, particularly autoimmune disease, and the microbiome.
This guy is trying to figure out what is the ideal type and amount of fiber to feed the gut bugs, and what foods or supps to get it from. The discussion in the comments is always good, as many people, in varying degrees of ill-health, are trying to implement these ideas. A few have had remissions, a few have had some improvements, a few have gotten worse. There is a lot of junk here, but a lot of very good info, too.
This woman takes the science and tries to apply it to gut health for humans with practical recommendations. She had CFS and claims to be in remission from fixing her gut. Again, the comments are the most useful part, as people are discussing their trials, successes, and failures.
This one also takes all the available science and info on the gut microbiome and tries to make sense of it, especially as applies to chronic illness and inflammation. I think this writer may be an immunologist or a professor of immunology, but am not sure (I read so many of these things that I forget who is who).
"The animal-based diet increased the abundance of bile-tolerant microorganisms (Alistipes, Bilophila andBacteroides) and decreased the levels of Firmicutes that metabolize dietary plant polysaccharides (Roseburia, Eubacterium rectale and Ruminococcus bromii)."
Jeff Leach (and many others), after studying the Hadza hunter-gather gut flora, believes that the amount of meat and fat we consume is irrelevant. The main thing that is protective is the amount and variety of fiber and resistant starch consumed. This fiber and resistant starch feeds the good bugs and promotes diversity, which promotes health.
I hope some o this is interesting and useful.
Posts: 845 | From Eastern USA | Registered: Jul 2006
| IP: Logged |
Conversations on various bacteria, gut health, how to restore healthy gut function. http://restoretheflora.com/Posts: 845 | From Eastern USA | Registered: Jul 2006
| IP: Logged |
The Lyme Disease Network is a non-profit organization funded by individual donations. If you would like to support the Network and the LymeNet system of Web services, please send your donations to:
The
Lyme Disease Network of New Jersey 907 Pebble Creek Court,
Pennington,
NJ08534USA http://www.lymenet.org/
UBBFriend: Email this page to someone!
Printer-friendly view of this topic