Fecal Matter Transplant in Autism

I have written posts on this for ME/CFS, listed below — but a reader asked me specific for Autism. On Pubmed there was a number of studies on Autism and FMT, hence this article.

Autism Specific

Together, these findings suggest that MTT is safe and well-tolerated in children with ASD ages 7–16 years. MTT led to significant improvements in both GI- and ASD-related symptoms, and the improvements were sustained at least 8 weeks after treatment. Coincident with these clinical improvements, both microbiota and phage from the donors appear to have engrafted, at least partially, in the recipients. This shifted gut microbiota of children with ASD toward that of neurotypical children is consistent with the hypothesis that gut microbiota may be at least partially responsible for GI and ASD symptoms. 

Microbiota transfer therapy alters gut ecosystem and improves gastrointestinal and autism symptoms: an open-label study.[2017]

Bottom Line

The largest studies are from China with 73 patients. One of the typical problem with small studies is bias in the selection of candidates as well as reporting averages. With the China study we get 61.6% improvement; this agrees with “most improvements” (i.e. over 50%) from other studies.

The selection of the donor is critical. For example, if the child is low in Akkermansia muciniphila, the donor should be high (i.e. above the median at least, ideally at the 75%ile or more). A 16s microbiome profile should be done on the child and candidate samples before proceeding. “Bottled off-the shelf FMTs” will likely have poorer success rates.

This is not a cure, it is an improvement. The greatest benefit may occur in children with gastrointestinal symptoms (speculation ).

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