FMT In The Bahamas (Part I): Why Am I Here?

Those of you who receive my newsletter or watch my instagram stories likely know that I am in Nassau, Bahamas for two weeks to undergo an experimental procedure called fecal microbiota transplantation (FMT).

In a series of posts, I will be sharing about my experience and making recommendations to help those of you who decide to try this procedure.

First, I will start by telling you what brought me here.

My Digestive Health Story

My journey with irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO) began a long time ago.

I remember digestive symptoms at least back to age 14 (that was in 2006), but have likely had them my whole life.

I was a super colicky baby and developed daily headaches in first grade that turned into frequent migraines by middle school. All of these conditions are believed to be rooted in digestive dysbiosis.

But I didn’t know that back then. I thought it was normal to feel unwell. Until my symptoms became severe.

I didn’t officially receive an explanation for my digestive symptoms until I started working with a naturopath. I was diagnosed with IBS in 2012 and then SIBO in 2014.

Getting My SIBO Under Control

In an effort to improve my digestive and immune health, I made some huge life changes. The biggest of these changes was abandoning the stressful (but financially promising) corporate career path I had chosen in college for one that would allow me to take better care of my health.

I began learning everything I possibly could about health, nutrition and SIBO. I went back to school for a Master’s in Nutrition degree and studied with top naturopaths in the SIBO and digestive health world.

Then I began applying what I had learned (along with working with a naturopathic doctor) to my own healing journey. It took a lot of trial and error, but by about 2 years into my SIBO journey, I figured out the right combination of diet, supplements, and lifestyle hacks to make me feel pretty healthy on a regular basis.

For about two years, I had a routine that worked quite beautifully for me. I used a combination of the probiotic VSL#3, a strong prokinetic called Resolor, and a diet I tailored to my unique needs. Occasionally, I used other supplements to get me back on track.

When symptoms would flare up a little, I could get them back under control in a day or two using one or more of the following:

• Ginger capsules (I like Nature’s Way brand)
• Vitamin C with Quercetin & Bioflavonoids (by Integrative Therapeutics)
• Colostrum (the brand I loved stopped carrying it)

I typically recommend purchasing supplements through a site such as Wellevate, rather than Amazon, when possible. That way you can ensure that the product you are getting is authentic and that it was handled properly (especially important for products that require refrigeration).

Diet For SIBO

I almost strictly avoided gluten, dairy, eggs, oats, and soy because those are foods that set me back for several days when I would eat them. I mostly avoided fruits, but would consume bananas and berries (strawberries, raspberries, blueberries) a few times per week or daily.

And then I would do something I call being “FODMAP conscious.” What I mean by this is that on days when I felt really well, I would consume more FODMAP containing foods such as onions, garlic, and other high FODMAP veggies. But when I would have a rough symptom day or series of days, I would ease off the FODMAPs.

I was super happy with the fact that I was able to reintroduce sulfur foods (I was once very sensitive to kale, spinach, broccoli, and other high sulfur foods). This happened about a year into my SIBO journey after taking the probiotic VSL#3.

Even though to the average person, a diet free from gluten, dairy, eggs, oats, soy, etc. sounds restrictive, it actually felt pretty lenient for me because during the worst of my SIBO journey, I seemed to react to nearly every food I ate (except meat, oils, and like 3 vegetables!). Being able to tolerate high sulfur foods made my diet feel more sustainable and nutritious for the long-term.

I told you what I wasn’t eating during my “maintenance diet”, but what did I eat? Vegetables, fresh herbs, and spices. Lots of them. Organic when possible- for all my food. I also aimed for high-quality meat and seafood, nuts/seeds, legumes, gluten-free grains (opting for whole grains over refined ones), and healthy oils like olive oil and avocado oil. I tried to keep sugar to a minimum, but definitely am one with a sweet tooth!

And Then I Had To Take Antibiotics…

And then in 2017, things took a turn for the worse.

I started trying to be a superwoman overachiever again. I wanted and tried to live a more “normal” life. I wasn’t getting enough sleep so my immune system wasn’t happy.

I ended up with a kidney infection that required me to take an antibiotic called nitrofurantoin. Within two doses of the antibiotic, I had symptoms of a vaginal yeast infection. It was only my second time ever having a yeast infection (and the first time it went away right away).

My doctor instructed me to discontinue the antibiotic and to take probiotics. I bumped up my dose of a strong probiotic called VSL#3 for a few days and it seemed to go away. So I thought the issue was resolved. But over the next several months, I began to develop mysterious symptoms (later found to be caused by vaginal yeast overgrowth):

• Sore throat, especially upon waking
• Extreme fatigue, especially in the afternoons around 2 PM
• Very low ferritin (9 and 14 ng/mL at the two times it was measured)- this occurred despite eating meat and not having any other obvious risk factors for iron deficiency
• Discomfort with urination- it was minor, but basically felt like early signs of a urinary tract infection (UTI)- but almost all the time…I went to the doctor multiple times for a urine test to check for UTIs, but the dipstick never showed signs of infection and the cultures came back normal (other than showing mucus which is a sign of inflammation).

I went to several doctors to try to get a diagnosis, but everyone was stumped. They tested for mononucleosis, cytomegalovirus, bacterial vaginosis, urinary tract infections (again and again because it felt so much like one), sexually transmitted diseases (by the way, did you know it is super easy to order STD testing online?), and a whole host of other tests that I can’t remember.

I was even referred to a urologist who wanted me to undergo cystoscopy as part of a work up that would likely eventually lead to the unhelpful diagnosis of “interstitial cystitis”. And that procedure would require taking another antibiotic…

It wasn’t until 5 months later during a routine women’s health exam (two weeks before I was scheduled for a cystoscopy that I then cancelled!) that my doctor connected the pieces of the puzzle. She said she could literally see the yeast (based on the type of discharge produced).

I was confused at first because the urologist had tested via a yeast culture and it was negative! But my doctor told me that test is not very sensitive and was likely a false negative. So she sent me for a more sensitive test called a wet prep or wet mount. It was quick and painless and sure enough, she was right- yeast was brewing.

It is my theory that because I was eating a nutritious diet that mostly avoided yeast’s favorite foods (dairy, gluten, sugar), the infection was slow to develop and didn’t present like a typical yeast infection.

So we began treating the yeast. And I started experiencing relief immediately. But I developed resistance to the first antifungal really quickly. And with each subsequent treatment we tried that were aimed at yeast, my symptoms improved, but only until the resistance built.

Here’s everything that helped me find relief from symptoms of vaginal yeast overgrowth (in order from most to least helpful):

• Tea tree oil suppositories (on Amazon)
• Avoiding sugar/fruit
• Thorne SF 722 (on Wellevate)
• Marshmallow root tincture (on Wellevate)
• Boric acid suppositories (on Amazon)
• Priority One Urinary Tranquility (on Wellevate)
• Nystatin (prescription)
• Ginger (Nature’s Way Brand on Wellevate)
• Plenty of rest
• Genestra Candicin (on Wellevate)
• Uva ursi tincture (on Wellevate)
• Diflucan (prescription)
• Monistat (at any pharmacy)
• Probiotic suppositories (I used a needless syringe, sauerkraut juice, and a “candlestick” yoga pose in the bathtub)
• Saccharomyces boulardii (Klaire Labs on Wellevate)
• Biocidin (on Wellevate)
• Priority One Biofilm Phase II Advanced (on Wellevate)

As you can see, I tried a lot of things. My doctor ran out of ideas. And I wanted a sustainable solution.

Frequently Asked Questions About FMT

I have gotten lots of questions about fecal microbiota transplantation (FMT) since sharing that I was undergoing the procedure, so I wanted to take a moment to answer them here for those who want to know more:

Q: How does it work?

A: Healthy individuals (in the UK) with diverse microbiomes donate stool. That stool is then concentrated so that it more closely resembles a super potent probiotic than poop.

Then, the FMT patient receives the implant through the rectum (bum) via a very small tube. This happens once daily Monday-Friday for 10 days.

The idea is that a diverse microbiome has been associated with a better state of health. But those with chronic health issues such as autoimmune diseases and digestive disorders often have poor gut microbial diversity. The critters in our guts are super important for regulating the immune system. So by introducing good ones, the hope is that the immune system, digestive system, etc. will function better.

Q: Why the Bahamas?

A: Well, my understanding is that, in the US, it is only legal for doctors to administer this procedure for individuals who have a C. dificile infection that has failed antibiotic treatment.

So, the Bahamas is the closest place to the US that performs the procedure. They are affiliated with the Taymount clinic in the UK so you could also go there.

Q: How much does it cost?

A: About $10,000..(yes, I am talking U.S. dollars). And that does not include lab fees for tests back home prior to treatment, airfare, lodging, food, or transportation.

Q: What are the risks?

A: The most pertinent risk is receiving a communicable disease (virus, bacteria, etc.) from the donor implant. However, the donors are healthy, screened thoroughly, and then the implant material itself is also screened.

Otherwise, the procedure is quite safe. In your initial appointment, you will have an opportunity to discuss risks with the doctor. They say it is safer than a blood transfusion!

Q: What is the success rate?

A: I wish I had taken notes from my initial consult (it was several months ago) because I am not sure I remember the numbers correctly.

But I think I remember them saying that the success rates (based on checking with patients 3 months after treatment) are different based on the condition being treated:

• Clostridium dificile (C. diff) infection: 90%
• Inflammatory bowel disease (IBD): 80%
• Irritable bowel syndrome (IBS): 70%
• Other disorders (such as MS, Parkinson’s, Autism, CFS, etc.): 50%

Seeking A More Sustainable Solution

Due to the high cost of FMT, it is not the kind of thing that you jump to right away.

I had thought about FMT earlier in my SIBO journey (when I was reacting to nearly all foods) and consulted FMT expert Dr. Mark Davis. He’s the one who recommended I try VSL#3 first!

And since I got so much better, FMT became less important. But FMT has always been in the back of my mind. One major reason is that I would like to be healthier before deciding to have children (since it is believed that the mother’s microbiota plays a big role in regard to what the baby gets).

But then at the beginning of 2018, a family member asked why I hadn’t already tried FMT. The big answer: financial risk.

But realistically, I have spent way more on health care costs over the past 4 years than the cost savings that a sustainable solution would provide. So FMT, while financially risky, could actually prove to be the best option financially in the long run.

That’s when my family member stepped in to help. And FMT became within reach. I scheduled an initial consult with the Bahamas Medical Center to determine whether I would be a good candidate.

My guess was that I would. And the doctor agreed.

Because the likely root cause of my various health issues is gut dysbiosis (I inherited a crappy gut and then took 15-20 rounds of antibiotics during my lifetime). I also LOVED sugar as a child and because I was skinny, everyone always told me it wasn’t a problem. But it was probably just destroying me on the inside.

So I took the leap. And I am now in the Bahamas. I’m hoping for the best, but also understand that it is not a golden ticket. All I can do now is relax, wait, and eat lots of nutritious food!

Stay tuned for part II & part III of my Bahamas FMT Journey. You can also find me on Instagram (I’m most active there!), Facebook, or sign up for my newsletter.