alt Hacker NewsFecal transplants for autism deliver success in clinical trials (2019)
Comments
>Editor's note: Readers often ask us for follow-ups on memorable stories. What has happened to this story over the years? This article was originally published in 2019 but it has been re-edited and updated with new information current as of April 7, 2025. Enjoy!
Now that is something that should be done more often - especially in science journalism, but not only. We cruelly lack long-term vision - not only forward but backwards too.
I think this is the clinical trial registration: https://clinicaltrials.gov/study/NCT03408886?tab=results
It is marked as having results submitted but quality review has not been completed.
N=60 and a placebo group, which is better than the N=18 and no placebo group of the first study.
There have been so many small scale trials showing amazing autism improvements that failed to replicate in larger, better controlled trials. I wouldn’t get excited yet.
The typical pattern is to show unbelievably good results in the first open-label trial with a small number of patients (their n=18 trial that claims to have cured severe autism in many children), squeak by with some marginal improvement in the next trial over placebo, then the third trial becomes a game of trying to keep the study small enough that they can hope to p-hack a result that the FDA might accept.
Grate example of how misleading just reading headlines can be, even if the headline isn't intentional misleading/click bait.
> reduce autism symptoms
> chronic gastrointestinal issues are a harsh reality
> boosting microbial diversity
> when [...] treat those gastrointestinal problems, their behavior improves
Through my opinionated take is:
- gastrointestinal issue are a common comorbidity of autism
- fixing that help autistic people to mask better/easier
- which makes a lot of sense as gastrointestinal issue are very stressful and so is masking. It's quite common that autistic people under stress have a harder time masking
- and masking is removing many of the "symptoms" of autism at cost of stress and other risks (e.g. depression), and society(^1) is conditioning(^2) children to mask autism subconsciously all the time
(^1): Pretty much any society out there.
(^2): Both intentional and accidental. For most autistic people masking isn't a conscious choice, but something through live so strongly reinforced that it's done unconsciously even if they don't want to in any situation except a private one with at most some very trusted people around.
---
Through a much more disturbing implication from this article is that at least in US/Arizona children with gastrointestinal issues commonly do not get appropriate treatment... Or else they couldn't have done the test as they wouldn't have found a non highly selection biased sample of autistic children.
Like treating of gastrointestinal issues shouldn't be a thing you do to reduce autistic symptoms, but something you do anyway. Even if not for quality of live, then for the reason of such issues often causing much more server long term issues if they stay untreated for years.
>> In early 2022 Krajmalnik-Brown and colleagues patented a specific bacterial formulation and spun-off a commercial company called Gut-Brain Axis Therapeutics.
I was a little surprised to see this.
So the university researchers use time and money from the university to make a discovery, extending on previous published research, and then patent it and start their own for-profit?
Excuse my ignorance, but is that how it's done generally? Where's the upside for all those who are potentially affected?
It kinda makes sense - Presumably the university is involved somewhere still, and it needs to be commercialised somehow, but..
> Prior to the study, 83% of participants had "severe" autism. Two years later, only 17% were rated as severe, 39% as mild or moderate, and incredibly, 44% were below the cut-off for mild ASD.
Pretty incredible if true!
I got bad chronic constipation after four years as a strict carnivore. I didn't get relief just by adding back fiber, but I did by adding fermented foods like kimchi. I wonder if ferments are a more natural way than fecal transplants to repair the gut microbiome, possibly treating autism. Studies have been non conclusive, but this story makes me think it's worth pursuing.
I would still be cautious with such findings. Many autistic people are picky eaters, also some of them have issues with peristalsis. This might affect the microbiome as well. While it's plausible that it might help a subset of people, we should not overgeneralize since autism is a very heterogeneous condition, usually with pronounced genetic predisposition. Overall, it doesn't seem to be a cure.
Serious question: could this work in reverse if you took a fecal transplant from someone with “severe” autism and gave it to someone below the ASD cutoff?
What's more plausible? Did they cure low functioning autism in two years? Or did they simpily miscategorize the kids and the kids grew out of their diagnosis as they matured?
Title is a bit misleading. It’s not a fecal transplant. It’s tablets and powder (for the pitt-hopkins cases) of microbes from fecal donors. Consumes orally.
More like fecal food?
So if I eat somebody else's poo I'll become more social?
An unexpected result for sure.
First website where I've had to disable first-party JavaScript just to be able to read a text-based article. Even Firefox's reader mode was hijacked by their anti-ad-blocker script. Shameful.
I wonder if there’s any study linking C-section birth, autism and microbiota? Or newborns that have to stay in incubators?
I understand a newborn gets its microbiota naturally by contact with the mom in the first days, maybe all the sterile environment involved in surgery changes that.
AFAIK fecal transplants do not work well long term, has there been any research in making them more sticky? Lots of things you could trial but I have a feeling it’s the immune system responding to the right bacteria incorrectly…
They also used to think IBD (colitis) was an autoimmune disorder, but now more research is shifting to gut biome and genetics targeting non-immune pathways.
Being told to eat shit has been typical of most of my experience of trying to get normies to understand my mild nuerodiversity.
My slightly more serious experience is that in my late 20s I started getting digestive problems and gaining weight. I feel like my neurodiversity got worse, but that could easily be that environmental factors exposed it.
How does one take advantage of a study like this? I would be difficult to get medically sanctioned poo right now. So what can I do? Coprophilia seems high risk.
I mean I can eat Kimchi and oats, but that seems more about encouraging the bugs that are already there than replacing missing bugs. Are we close to over the counter poo pills?
Pretty funny that picky eaters are hobbling their own minds and bodies and giving themselves severe autism.
Just stop eating chicken nuggets and french fries, kids. Have some vegetables.
There's a greentext that's been floating around for a while, I don't know the original author and can't remember the exact text to search for it, but it's along the lines of
> my deepest fantasy is that one day I'll be in the hospital for some random thing, they'll take blood for some test, and then when they read the results, their eyes will go wide and they'll call for a consult. The other doctor will read the results and say "you don't have the nutrient?! How do you live? You're so brave". They give me a shot, and just like that, I'm able to conduct myself in society, understand social cues, hold my attention on anything i want for any length of time, etc
... so perhaps the Nutrient is a product of a gut bacterium.
I’ve heard that fecal transplants are also good for curing former lawyers. The bigger the hose the faster the cure.
What's the incidence of autism in country towns without functioning septic systems?
Yeah i'm not doing that. I'll just stay this way.
So there is finally a huge job market to for all those affected by AI-driven workforce purges: that of fecal donorship!
All applicants will be fed recycled byproducts for free.
no placebo arm. result could be due to unisolated factors present in clinical trial fixturing.
Maybe that's why some people love rimming? Is that a natural instinct to get more microbiome?
First they gave them the name "assburgers" (aspergers) and now this is the solution medicine is proposing?
It's like the medical community wants all high functioning autistics to get bullied like hell in their formative years. Similar irony to "lisp" being unpronounceable by the very people who have a lisp.
Certain gut bacteria supplements are actually amazing. I found they lift brain fog substantially the next day after taking.
I find this interesting because my first awareness of a link between gastrointestinal problems and autism was in the retracted so labelled "fraud" paper by Andrew Wakefield et al in 1998 which noted a link between gastrointestinal disease and autism in the subjects of the study.
In fact it is the subject of the paper, not the MMR vaccine which was the cause of the "controversy".
[dead]
[flagged]
So all I gotta do is eat some poop and it will save me from becoming a handsome, funny, unique genius?
The number of stories I’ve read in the last 15 years that amount to: “desperate after years of trying everything, we bought a blender and ground up my wife’s shit and put it up my butt, and within a 24 hours I was totally fine”
Is kind of impressive.
Personally, anyone looking to get a fecal transplant from Sir Demis Hassabis will have to line up behind me. I want to be first in line.
Absolutely outrageous/hilarious clickbait title. It's not for autism but totally opposite.
Many autistic children have extremely limited diets. For example, a geneticist friend of mine saw a case where an autistic child had been referred for genetic testing because of horrific, chronic, spontaneous wounds on gums and skin. Turned out to be scurvy, because he had exclusively eaten Wheat Thins for the last 3-4 years, which aren’t fortified with vitamin C.
I would fully expect that a monotonous diet leads to a heavy skew in the gut microbiome as specific bacterial species that thrive on that diet are selected for, others against. It makes some sense that a fecal transplant could repair the damage. If the diet has shifted or expanded, the transplant could lead to long term benefits by restoring newly-viable bacterial species, perhaps by facilitating digestion of the new types of food.
I’d be curious to see a factoring out of the diet composition, gut microbiome, genetics, and severity of autism symptoms.