Stool-derived Postbiotics with Dr. Andrea McBeth: Rational Wellness Podcast 425

Podcast: Play in new window | Download | Embed

Subscribe: RSS

Dr. Andrea McBeth discusses how Stool-derived Postbiotics can restore gut health with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.]

 

Podcast Highlights

---

Dr. Andrea McBeth is the founder and CEO of Thaena, a pioneering microbiome therapeutics company. She has a Bachelor’s in Biochemistry, focusing on molecular biology, and a Doctorate in Naturopathic Medicine. Early in her career, Andrea directed her ND clinical practice toward functional GI disorders and autoimmunity, launching one of the first stool banks for fecal microbiota transplantation to treat Clostridioides difficile infections.  Driven by the interface between gut microbes and human health, Andrea invented ThaenaBiotic, the first human-derived postbiotic supplement. The website is Thaena.com.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

______________________________________________________________________________________________________________________________________

---

Podcast Transcript

 

Dr. Weitz:  Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates and to learn more, check out my website, drweitz.com.  Thanks for joining me and let’s jump into the podcast. 

Today we’ll be speaking to Dr. Andrea Macbeth about postbiotics. Dr. Andrea Macbeth is a naturopathic clinician who has been focusing on functional gastroenterology and the microbiome since 2015. She became an expert at using fecal microbial transplants as a form of therapy, especially for c diff infections, and she started a stool bank.  She is now the founder and CEO of Thaena, Inc. And she has developed a breakthrough fecal-derived postbiotic nutritional supplement, phenobiotic, made from sterilized poop that enhances the health of the gut and overall health. And that will be a focus of our discussion today. So Dr. McBeth, thank you so much for joining us.

Dr. McBeth: Thank you so much for having me. It’s my pleasure to be here.

Dr. Weitz: Great. So tell us how you got involved with fecal microbial transplants.

Dr. McBeth: Yeah, I was, I like to joke, I’m a researcher, scientist that like fell out of academia, fell down the hill to become a naturopath. Okay. So I’m a naturopathic provider.  I was a molecular biochemist, kind of focused before that in my academic career.  I didn’t finish my PhD.  I left to focus on taking care of a family member who had cancer.  And then in that process found the journey and desire to do more preventative medicine, and so became a naturopathic provider.  Got really involved in the gastro, GI, autoimmune, kind of focused naturopathic community, right? And worked with a doc named Mark Davis, who sort of pioneered fecal transplants in Portland, Oregon in the early days when it was being introduced in Boston and other parts of the US healthcare system for the treatment of a disease called c diff.  So fecal transplant is what it sounds like. It’s the delivery of healthy donors stool to a recipient, and it’s super effective at treating an infectious GI bug called C Diff. And yeah I was really enamored with the microbiome. I found it fascinating. It was a great bridge for me between my old life as an academic and I, my understanding of why all these tools we use are so important.

Dr. Weitz: And my understanding is there’s emerging evidence of fecal microbial transplants being beneficial for ulcerative colitis and Crohn’s and maybe a bunch of other conditions. I’ve heard Dr. David Perlmutter talk about using it for neurological conditions.

Dr. McBeth: Yeah. So what is really cool and sort of unique is in medicine in particular in the US healthcare system, we normally start with a theory or that pharma starts with a theory, they create a drug and they test it in a disease.  And very rarely do we see something like fecal transplant that sort of works backwards. It’s an ancient therapy that’s mentioned in Chinese literature. It’s standard amendment. Of medicine and veterinary medicine and was reintroduced after being used in the fifties for this antibiotic resistant pathogen.  And what that did is challenge what we think we knew about the microbiome and open a doorway to clinical trials. Hundreds of [00:04:00] them for everything from liver disease, neuroinflammation, autism, Parkinson’s, immunotherapy responses, post bone marrow transplant, graft versus host disease. They use it…They looked at it in pediatric diseases. I mean, kind of anything you can imagine and in mice as well for basic science. And what it did is say. We have no idea how it works, but clearly the microbiome impacts the brain and the immune system and our metabolic system in ways we never even thought possible before.  And so it, it opened a whole, it challenged neurologists to rethink how they think about the gut in ways that I think functionally we do that. But it’s really cool to see that sort of adopted and challenged on a 10 year timeframe in the US.

Dr. Weitz: Cool. I noticed that among your studies, you spent some time studying bile acids.  And I’m just curious if you have any clinical pearls about bile specifically because it’s starting now to be an add-on to some of the stool tests. Diagnostic Solutions now has an add-on to measure bile acids and short chain fatty acids. And I’ve been thinking more about bile acids. I have a few patients with bile acid malabsorption and I, yeah.  I know that bile acids are one of the players, and I wonder if you have any thoughts about how clinicians can think about bile?

Dr. McBeth: Yeah, so again, similarly really interesting story. We thought bile acids. In traditional biology, there’s four of them, right? And they get conjugated and de conjugated, and it’s the cycle back and forth between the liver and the gut microbiome.  And they’re thought of as the, these four bile acids get used to excrete stuff, right? That’s sort of our traditional biology understanding in a really simplified way. But it turns out that with the [00:06:00] microbiome research, there are thousands of versions of bile acids and. Different bacteria can conjugate different molecules to bile acids.  And what we are now starting to appreciate is that bile acids aren’t just this thing that helps us excrete fat. It’s actually a signaling transporter molecule that brings, in theory, nutrients are small molecules to all different parts of our body. And they’re the really interesting researcher at UCSD in San Diego named Peter Dorsen.  And all he does is study bile acids from the perspective of how microbiome bacteria make them. And he uses mass spec to sort of look at the molecules. And then he has done really interesting work tracking where they go in a mouse, for example.  And there are specific bile acids that go just to the frontal lobe or the cortex of the mouse brain, and they have very specific [00:07:00] conjugates with them.

And so what we are now starting to think about when we think about bile acids is that they actually may be important nail male delivery systems for nutrients to distal tissues and. Adding complexity to the importance of the microbiome in our bile, but also just emphasizing how crucial having these core functions working.  Because if we, I mean, I think about people who get their gallbladder and appendix removed a lot, right? And I understand that saves people’s lives sometimes, but the cost of that. When we start to think about what happens when people lose functionality of making these foundational transporter molecules is probably more far reaching than we appreciated.  And when you see patients with bile acid malabsorption or [00:08:00] other dysbiotic associated issues with this. You know, I just am reminded that it’s such a critical orchestra–mouth to anus–with our vagus nerve and how central appropriate functionality of our nervous system and expression of all these, whether it’s digestive enzymes, or bile acids or pancreatic enzymes.  They impact the environment and then having a healthy microbiome is central to being able to take those things and redistribute and put them in the places they need to be. That’s probably more than you wanted about bile acids, but I just think no I, it’s so fascinating.

Dr. Weitz: I’m trying to figure out how to think about bile acids and what seeing bile acids come up on a stool test means and what role that’s playing in patients.  Is it, you know, when a patient has like breakthrough diarrhea, is that a bile thing?  How do you know, and you know…

Dr. McBeth: I think we know a lot less than we think we do, but the patterns are important and I wouldn’t negate the importance of having, if, you know people’s bile acids are out of whack, right. That is potentially impacting their brain, for example.  And so it is something we should pay attention to and make sure it’s hard to know what is health, right? We still don’t actually have a good definition of a lot of these biomarkers and stool testing even. But what we do know is if it is out of balance and it is out of whack, it has far region consequences.  And so doing what we can to sort of re equilibrate probably has benefit and. I don’t know the right answer of how to do that, but we have pretty good tools for bile acid malabsorption and nervous system patterning. And you know, those people that you see that just everything’s outta whack ’cause they’re in fight or flight versus people that have just one thing wrong.

Dr. Weitz: So I, I mentioned post biotic. I’m wondering for helping listeners understand what we’re talking about. Could you maybe give us a brief definition of what a prebiotic, a probiotic, and a postbiotic are?

Dr. McBeth: Yeah, so I, I caveat this with, there’s scientific definitions that are sort of like firm in the sand.  And then there’s marketing definitions that we’ve developed to help people understand things and or supplement companies have developed to help sell things.  And prebiotics and probiotics and postbiotics are definitely the latter.  They’re marketing terms, I think, more than scientific terms. And there isn’t true consensus on what they mean.  There is a organization called ISAP that has defined a probiotic to be a. Studied strain of bacteria that’s been shown in clinical trials to have health benefits. But we all think about probiotics as like all the good bacteria that come on fermented foods. And even some of the time we think about just the good gut bugs we have in our gut as probiotics, right?  The live material. And I think it’s fair to just put all probiotics into the. A live bug that can live in our gut and or on our skin or in our ecosystem of our body and provides benefit. And that’s loosely my definition. Okay. And that helps anchor what a prebiotic and a prebiotic is.

And a prebiotic is the food or nutrients or something that bug metabolizes or eats.  Then the thing that it produces when it eats that prebiotic is a post biotic. And I think of it as like a broccoli comes in, it gets digested. We have good bugs in our gut. They, those probiotics break down that broccoli into a post biotic, which may be butyrate, for example.

Dr. Weitz:  Right. Short chain fatty [00:12:00] acids that are produced by the bacteria in our gut.

Dr. McBeth: Yeah.  And the Isop definition is a little different and sometimes people call, you know, the lactobacillus you buy at the grocery store that’s been heat killed a post biotic. I think the most clear definition and the way that I like to think of it is it’s the thing that the probiotics make and it’s not alive.  It’s a small molecule or the dead parts after it’s been heat killed.

Dr. Weitz: Right. So why did you de decide to sterilize the poop in making your post biotic product?

Dr. McBeth: Yeah, so fecal transplant had all this early research, it’s like 90 plus percent effective at treating c diff. It was really cool to work with, right?  And I really loved having patients come in and have a tool that I knew could turn them from, you know, in and out of the hospital or really acutely ill to. Totally better in 24 hours. It’s like one of the coolest things I’ve [00:13:00] ever worked with. I love all of the naturopathic stuff, but fecal transplant was really cool.

Dr. Weitz: And by addition, how are most fecal transplants done these days

Dr. McBeth: either oral capsule, there’s two companies that made pharmaceutical versions. So there’s an oral capsule company and there’s an enema or like colonoscopy delivery version. Okay. And they both work, which is cool. And so we were working with it and the barrier was infectious disease risk.  We don’t know what we don’t know, and COVID came along just like other things of, in the history of using, you know, blood is a good analogy, right? Like blood donation, we can’t make synthetic blood. It’s too complicated. The same thing’s true for poop and. But you don’t know what you don’t know with blood.  And so the HIV epidemic really changed the way the regulators thought about human derived products for [00:14:00] good reason, right? And so when stool came along, they were concerned about the same kind of hypothetical, and then COVID happened and it was like, well, we don’t know if COVID could be in the stool and if it can be transmitted that way.  And so we had already been thinking about looking at a sterilized version of. FMT and that sort of was the catalyst to get there to say, okay, well we don’t have a way to test for infectious disease, so let’s just heat kill it, know it’s good, and then have a sterile version from there. And that actually ended up being really beneficial and working.

_____________________________________________________________________________________________________________________________________

Dr. Weitz: I’ve really been enjoying this discussion, but I just want to take a few minutes to tell you about a product that I’m very excited about. Imagine a device that can help you manage stress. Improve your sleep and boost your focus all without any effort on your part. The Apollo wearable is designed to just to do just that, created by neuroscientists and physicians.  This innovative device used as gentle vibrations to activate your parasympathetic nervous system, helping you feel calmer, more focused, and better rested. Among the compelling reasons to use the Apollo wearable are that users experience a 40% reduction in stress and anxiety. Patients feel that they can sleep.  Their sleep improves up to additional 30 minutes of sleep per night. It helps you to boost your focus and concentration and it’s scientifically backed. And the best part is you can get all these benefits with a special $40 discount by using the promo code weitz, W-E-I-T-Z, my last name at checkout to enjoy these savings.  So go to Apollo Neuro and use the promo code Weitz today. And now back to our discussion.

____________________________________________________________________________________________________________________________________

Dr. Weitz:  Let’s talk about your product and what kinds of benefits can be derived from this post biotic sterilized poop. And how it can promote health and improve the microbiome and what other benefits?

Dr. McBeth: Yeah, so it, it has a bunch of short chain fatty acids, like we mentioned bile acids.  The magic is probably in a lot of, a little bit of, a little bit of a lot of things. So tens of thousands of small molecules that go into it. And we think they’re working synergistically to bind immune receptors, modulate the oxidative stress of the gut. We know now that there’s little neuronal cells that stick into our gut and these small molecules bind them and trigger responses that mediate our brain.

Dr. Weitz: Yeah, I saw where you wrote something about those neuronal cells. What are those called?

Dr. McBeth: Neuropod cells. I love em. Oh yeah. Terrine that. Okay.

Dr. Weitz: That’s fascinating. I’d never heard of that before.

Dr. McBeth: We just like just discovered them. Right? Like science just discovered that there’s neuronal cells sticking into the microbiome Miu like 10 years ago.

Dr. Weitz: Wow.

Dr. McBeth: I know. And they can trace ’em. So they do this cool stuff and. Neurobiology where they use a rabies virus that has a green floor for on it. So it’s like neon green and you can inject it into a nerve like in the gut. And the way the rabies virus is it transmits and travels back to the brain. And so you can actually trace a nerve from the gut back to the part of the brain that it’s connected to.  And they do this in mice and rats, and they can see these neuro pod cells are going to all different parts of our brain.

Dr. Weitz: So these nerve cells are like receptors.

Dr. McBeth: They’re activated by like calcium channel receptors. And these postbiotics are what? Like turn the light switch on. Turn the [00:18:00] light signal on.

Dr. Weitz: Really? Wow. Are those playing a role in motility?

Dr. McBeth: Yeah, they’re playing a role in how we make decisions in our prefrontal cortex and wow, how our nervous system is patterned. And you know, really, it really goes a long way to challenge like, who’s in charge here?

Dr. Weitz: So it maybe sort of helps explain things that we’ve been saying.  Oh, well, it’s because of the vagal nerve. And it may be really the neuro pods that, you know, we’re seeing some of these benefits of probiotics and gut bacteria. Definitely careful akkermansia affecting blood sugar and maybe through these neuro pots

Dr. McBeth: partly. And then the other place that. This is really interesting is, you know, our gut microbiome and our liver are constantly communicating.  We have this really tight SAS link between the liver and a lot of that [00:19:00] metabolic impact that we see from like pendulum and amania and even bile acids can go to the liver. Educate T cells there, or impact our insulin or our ghrelin. I mean, even, I think just the fact that GLP one now with Ozempic and all this, we are familiar with the concept of a GLP one agonist.  GLP one agonist drugs are just a longer life version of what we naturally make in the gut from these receptor. Relationships. So our gut’s constantly making GLP one, but like on an hourly basis from tryptophan binding receptors or bile acids, binding receptors. And then our gut cells are enteric. Colon lining is making GLP one.  So there’s all kinds of stuff going on there that Wow. Kind of at like the very tip of the iceberg on understanding.

Dr. Weitz: So what kinds of GI conditions can these [00:20:00] postbiotics that the antibiotic help, is it beneficial for sibo, I-B-S-I-B-D, et cetera?

Dr. McBeth: Yeah, so we, we have the luck and the curse of being the first people to use this, right?  And like completely new to the market, right? And. Part of the advantage of that is so obviously

Dr. Weitz: there’s no randomized control trials, right. With thousands of patients. Right? Right,

Dr. McBeth: right. And so what we’re doing is piggybacking off theory from work that’s been done in small molecules like butyrate and sine and stuff.  But our product is in smaller concentrations, and so we’re not a hundred percent sure. And then we have all this fecal transplant data. We think there’s some parallel to that mechanistically, and then we’ve been using it clinically for several years and we have observational anecdotes that show it’s really great if your gut is like moving too slow or too fast, right?

What’s interesting is it can [00:21:00] help with people who are having too many bowel movements, but it also can help with people that haven’t had bowel movements and increased motility in like a couple days. It works in a way that seems to be like a buffer, like a pH buffer, right? Like so whatever direction you’re out of balance from SIBO or whatever, it brings you back to that homeostasis probably because it’s 14,000 different molecules and whatever.  You’re out of balance and it’s sort of nudging you back to that center.

Dr. Weitz: Have you started trying to figure out exactly what the composition is with all these different molecules?

Dr. McBeth: Yeah, we actually bought a mass spec like two days ago. Okay. From an auction. It’s like a very fancy piece of equipment to look at ’em.  We’ve like paid other people to do it before, you know? Right. But I think of it as like the new gold rush. Like really there’s so many important molecules in our poop and nobody has, like, we just haven’t looked [00:22:00] for it before. Right. So we have run a lot of metabolomics. I have like Excel sheets of lists of stuff.  And I put it into chat JBT and ask it to tell me what it thinks. And we’re sort of at this very early stage of exploration, but we have a, we have an r and d arm of the company that will work on kind of parsing out what is doing what, if we can, you know, there’s a lot there, but. I think it’s the future.

I, so here’s another anecdote I like to use is traditional pharmaceuticals in our medicine. We’ve like traveled to the jungles and looked at the bottom of the ocean and we’ve, like, we’ve skipped, we’ve looked all over the world for molecules, right? That do something. And a lot of our really important medicines come from plants and places, but.  We have been co-evolving with these molecules in our gut since the beginning of time, so they don’t [00:23:00] have acute toxicity, but they still functionally do really important jobs. And so if we can start to understand what postbiotics are, the ones that hit that nerve, that tells me to chill, you know, to not have anxiety, I think we’re gonna have a lot better tools to help people in the future from this gut.

Dr. Weitz: I watched a YouTube video where you were talking about the postbiotics potentially being beneficial in reducing visceral hypersensitivity, which is something that we often see in IBS patients. Can you talk about that?

Dr. McBeth: Yeah. So, we. I mean, the visceral hypersensitive is really cool, right? Like what we are learning about it and the way that our nervous system patterning Well,

Dr. Weitz: it’s really, I think, common and often, maybe over often overlooked and yeah, not really sure how to address it.  We use curcumin, we try different things, but [00:24:00]

Dr. McBeth: yeah, and it’s like imagine that the fire alarm has just been going off and that patterning has gotten reinforced so much that. You know, the underlying mechanism probably is a combination of oxidative stress and inflammation based on some basic science. Okay.  And nervous system patterning. Right. But the reason we think this might be helpful for that is it kind of lays a blanket over that fire in a different way than just maybe like curcumin does. Right. It turns down that signaling through this sort of multimodal interface of oxidative stress and immune and nervous system, like those neuro pod cells are cool, right?  Because they can bind and send a signal and tell us to chill. But if you don’t have receptors and it. Is a sad neuro pod cell because you’ve had malnutrition or malabsorption or you know, chronic IBS or whatever reason, antibiotics, a [00:25:00] lifetime of preservatives and just whatever that neuro pod cell, maybe it doesn’t work all the way.

Or like the little mitochondria that bring the calcium to turn on that switch doesn’t are sad, right? Our MIT mitochondria gets sad because we’re sort of poisoned, right? So if we can repair that by putting in the nutrients that a healthy microbiome represents from a healthy person, we can start to repair that damage and rebuild that mitochondria.  We did preliminary early work in a model system, a little like worm, and what was really interesting is the antibiotic. Impacts a lot of mitochondrial genes and oxidative stress genes, though it’s sort of like the housekeeper of turning on that like baseline rest and repair that we lose when we see hypersensitivity or chronic dysbiosis.  However you wanna kind of define. [00:26:00] 

Dr. Weitz:  So are, define that, are these neuro pods part of the mucosal lining? Yeah. Are they involved with leaky gut in some way?

Dr. McBeth: I mean, I think. I mean the, one of the things I’ve thought about doing just for fun is like teaching a class on all the different types of cells that line our gut because we’re learning new ones all the time in the same way we like know very little about the microbiome itself.  You know, our human cellular biology is really complicated and in you imagine the bottom of the VI is this stem cell, right? And the stem cell can turn into a goblet cell, it can turn into a neuro pod cell, it can turn into a regular like endothelial cell. It can turn into, there’s all kinds of things that can like turn into, and then you get this lining.  And the amount of goblet cells that make mucus versus the amount of immune cells that are coming in. Dendritic cells versus the amount of neuro pod cells is all variable depending on the environment and how that set [00:27:00] that stem cell kind of core growth comes. And I just think. Well, so some of the best preliminary research I’ve seen is looking at goblet cells in our mucus layer and goblet cells.  You have to have enough of them to make the mucus and then you have to have your vagus nerve telling them to make mucus to have a healthy gut lining. And the same thing’s probably true. I don’t know as much about the enteric endocrine cells or haven’t read about their maturation the same way, but the all of this biology is kind of has that core.  We need the cells, we need enough of them and we need the signals to turn them on to be effective.

Dr. Weitz: And do these postbiotics enhance the gut immune system?

Dr. McBeth: Right? Yeah. So the axis I think about is the neuronal. We know gut brainin is like super strong, the gut immune cells. That’s why so many immune cells are.  [00:28:00] Are focused in the gut, right? The pyres patch lives there because so much of our immune education comes from the microbiome. And the microbiome is really like our first. Interface to the environment to tell us how to be responding. It’s one of its core functions as an organ really is adapting and telling us what’s going on in the world outside of us.  And then it, the third arm is the metabolic arm. So how we respond with insulin and process energy and fast and get satiety and all that stuff. And on the immune side. So much of us are walking around with like, again, a different kind of fire alarm of inflammatory cytokines and overregulated towards, you know, TH one or TH two.  And what we really need is the T regulatory calm down signals. And it turns out that the microbiome is really central into turning those on and these [00:29:00] postbiotics in particular

Dr. Weitz: interesting. So right now a lot of us are using immunoglobulins as part of our treatment protocols. How we using this post biotic, interact with that?

Dr. McBeth: It compliments it. It’s a really good tool to add with IgG. I think it’s a really good tool to add with glutamine or nutrient powders or. Antimicrobials. It’s a good compliment for SIBO treatments. It’s a good compliment for mold and Lyme treatments, right? Because you’re repairing some of the die off or the kill.  The other thing I really like it with is N-acetylcysteine. ’cause N-acetylcysteine is sort of a detox and a biofilm disruptor, and this is complimenting that as well.

Dr. Weitz: So for those of us who have different phases of care, is there one phase of care that this would be better for or,

Dr. McBeth: yeah, towards like the end of the kill and toward [00:30:00] into the repair.  Okay. Like it’s very much a part of the repair and tolerance and right support phase. Right. And I also just say, now it makes sense. It tends to help people like the sicker they are, the more likely it is to benefit them, like the more screwed up their gut is. 

Dr. Weitz:  Right now there’s one of these immune products that we use partially because it’s been shown to bind some of the endotoxins.  I wonder if that’s something that this product does as well.

Dr. McBeth: I don’t think it’s overtly binding. I mean. Some of the classes of things we know this product is doing is it is, it does have anti-microbial properties, it does have bacteria sins and Okay. Things that would be, you think about all the different things microbes make to modulate their environment.  And so they’re making anti what we call bacteria sins, which are kind of like their own [00:31:00] antibiotics to compete against their neighbors. They’re an making antifungals to create, to like fight against their fungal neighbors. And then they’re making antivirals.

Dr. Weitz: Right. And you have bacterial phages from the viruses in the gut, right?

Dr. McBeth: Yeah. And then, you know, so there’s an a component of this that’s like anti. Specific things that the healthy gut didn’t want or was trying to compete. And then there’s a bunch of nutrients there. And I think of it kind of as like the loss micronutrient vitamins, like the bile acids or the brain that I can’t make.  ’cause I was a C-section baby and I have so many antibiotics at my life and I’m on. I have autoimmune disease and all these things, right. So like I probably don’t make the special prefrontal anti-anxiety, but

Dr. Weitz: Interesting. So do you have research currently underway on this product?

Dr. McBeth: Yeah, and I would, I mean, this is the first time I’ve done a podcast where I get a.[00:32:00]  Announce. We have this really cool partnership with a clinical trial company called People Science. And they ran decentralized clinical trials for pharma for a long time, and then they pivoted to the supplement space. And so we now, anybody can go to our website@thena.com and buy the product and anybody can.  Sign up for the Chloe app, which people science built and opt in to share their data. And it’s really just a way for us to collect all this anecdotal data in a meaningful way. Like, did you poop today? Did you take your, the antibiotic? How was your anxiety? How was your diarrhea, constipation, or whatever it is that you are sort of co-managing.  The app is gonna give us. Hopefully a few hundred people to really say, this is what we should do an RCT on a clinical trial.

Dr. Weitz: Right? Sure. Randomized clinical trial. So what is the [00:33:00] dosage that usually recommend?

Dr. McBeth: Yeah, the dosage is,

Dr. Weitz: and are there are different strengths or is it just one strength or?

Dr. McBeth: It’s just one strength at a hundred milligrams, and you can either buy a sample pack to see if it helps a seven cap pack. There’s a 30 bottle, 30 cap bottle, which I recommend generally for people as a one month, roughly one cap a day, and then there’s a 90 cap bottle for people just as the most cost, cost effective, but for dosing.  One CAPA day is our base recommendation, but it’s unique in that you can kind of use it when you need it or use it when you’re outta sorts, and you can taper up on it and you can just. You could use like four caps a day and then not any, so you don’t have to taper off of it. We recommend people start with one cap and then add another and go up if they’re gonna increase dosing, but you don’t have to worry about weaning off of it.  And it can be really great for acute [00:34:00] GI stuff and you can just decide to use it when you want to eat cheese because cheese doesn’t agree with you. But this kind of like. Gives you a break, right? Or

Dr. Weitz: anything? Is there best time of day to take it? Is it better with meals? Apart from meals?

Dr. McBeth: I think with meals in the evening is my general baseline recommendation, but again, there’s not, it’s.  We see very few side effects. So pe if people wanna take it in the morning and it’s easier for them and they don’t eat breakfast, totally fine. Are based there certain

Dr. Weitz: supplements you shouldn’t take it with.

Dr. McBeth: Not that we have found. I mean, I’d say the only place to be cautious is it does seem to turn on that orchestra, right?  Motility, stomach acid, pancreatic. And this is anecdotal, but if you’re taking a whole bunch of beane HCL digestive enzymes, I would just be cautious to not take too much. ’cause it might turn back on your stomach [00:35:00] acid. So, you know, use this as a tool to kind of wean one way or the other. If you are on a bunch of stomach acid, just kind of pay attention.

Dr. Weitz: Right. Are there any contraindications.

Dr. McBeth: No, I mean, stomach acid is the one that in the early days, people theoretically were concerned about. We haven’t really had adverse event reporting. Sometimes it does help heart like acid, but the only. I mean, again, it seems to help people that are out of sorts, right?  And then it, or if it does nothing, it’s worth trying a sample pack to see. It can help you with your bowel movements in 24 hours. So you should know if it’s gonna help you,

Dr. Weitz: Pretty quick. Do we know how f and t works? No. Okay. So. Once again, [00:36:00] the thought with probiotics and of course FMT, is that we have this damaged microbiome, and now we’re gonna, you know, basically reseed our guts with a new microbiome.  You know, we’re laying down sod and now we have a new beautiful lawn. But perhaps that’s not what’s happening. And I noticed in one of your, one of the articles you talked about how. We’ve learned that in some cases dead probiotics are as effective or even more effective than live probiotics.

Dr. McBeth: Yeah, we spent a lot of money, or like the industry spent a lot of money on marketing to say, probiotics need to be alive.  And our, the fanciest marketing was like the most CFUs of live bacteria and the best way to get it, and turns out that they just don’t en graft. That’s not how the biology works.

Dr. Weitz: So they’re basically [00:37:00] probiotics and maybe even FMT is. Do we think FMT is different? Does it reason there’s some take hold in your microbiome?

Dr. McBeth: There’s some evidence that fecal transplant and grafts, and that’s probably a component, especially in really sick people, right? So if you have an ecosystem microbiome that’s super healthy, you’re, nothing’s gonna eng graft, nothing’s gonna outcompete the guys that you already have there. But if you’re really sick, you have c diff, you took a bunch of antibiotics, you do have room for something else to come in.

Probably and in fecal transplant they see some, but there’s a washout period like fecal transplant. You do it, you feel better, but it’ll go kind of rebound back to your previous in six months to a year, you know? So I think it depends on, we all have a set point of our immune system that we. We established a set point with our [00:38:00] microbiome, like by the age of three, and our immune system similar to our metabolic set point.

It’s really hard to change that for any reason. You know, taking your appendix out would impact it. But taking antibiotics, you know, we’re all always gonna come back to that homeostasis. And so you can get yourself out of an acute dysbiosis or acute bad space, but you’re. You are not gonna be able to out engineer that set point very easily without really concerted effort of continuous dietary changes or, you know, input from something like a, the antibiotic.

And that’s part of the reason fecal transplant I think has not been, I think fecal transplant would’ve done better in conventional medicine in terms of. Applications and other diseases if it had been dosed more because c diff is a very specific [00:39:00] circumstance that’s different than most of the chronic diseases we deal with.

Dr. Weitz: Right. I think you mentioned that this could be used in cases of a flare. Like what about a patient, like with Crohn’s who’s having an acute flare? Is this something that you would think by itself or in combination could be beneficial?

Dr. McBeth: We don’t have any clinical research on IBD, but there’s research in fecal transplant that’s really strong for ulcerative colitis.  That’s interesting. I don’t think we’re gonna replace conventional treatment, but I think it’s a great tool for a flare and a compliment. And I actually think if antibiotics gonna help people, you’re more likely to help somebody when they’re in an acute phase rather than their baseline. And so without, you know, going too far into saying we know something we don’t.  Anecdotally it seems to support people in a flare. And I would love [00:40:00] to see more research looking at. Role because I think, again, where fecal transplant fell short was the way that they were dosing it in a lot of these IBD clinical studies. And that’s where it got like some preliminary good data, but the metadata is not great.  And I think just the clinical design, it’s weren’t very good.

Dr. Weitz: Yeah. And this

Dr. McBeth: is way safer because it’s failed.

Dr. Weitz: Right. Do you know Dr. Rebar? He’s a in integrative gastroenterologist in Los Angeles. And he does a lot of scoping and stuff like that. You should probably talk to him. He might be interested in maybe even getting involved in some of the research.

Dr. McBeth: Yeah, we have a collaboration with, a group at Vanderbilt looking at it and people who have had colectomy, so their whole or portions of colons or pouchitis, you know, where stuff that’s really hard and it’s just observational, they’re introducing it with their other stuff. But it makes total sense [00:41:00] that it would help people that are missing a colon.  Right, right. Because that’s like the whole thing. Yeah, is all these small molecules are made in a healthy ecosystem.

Dr. Weitz: I’ve always been amazed at that whole concept. You know, we, there’s just unbelievable amount of research on the benefits of the microbiome, and now basically you’re taking patients who don’t have any colon and you’re taking a huge part of their microbiome and it’s just not there.  And yet. There’s a fair amount of ’em that continue to thrive and do reasonably well for long periods of time.

Dr. McBeth: I mean, the human body is very resilient. We’ve seen anything, you

Dr. Weitz: wonder if it’s creating a new microbiome out of the small intestine. Yeah. Elsewhere.

Dr. McBeth: I mean, I’m sure if, and again, they we’re just like, haven’t done a lot of research into this, but like.  We know so little. Yeah. And the amount of sampling we’ve done and what we’ve looked at with taxonomic [00:42:00] sequencing, like and lacking functional information from that data. I mean, I wouldn’t be surprised if the small intestine microbiome is way more important than we think it is. You know? And compensatory too for when we have issues with the colon.

Dr. Weitz: Yeah. Are there some misconceptions about the gut microbiome that you think need to be corrected?

Dr. McBeth: The microbiome is used in marketing, and I am guilty of this too, right? Because I have a supplement company and I market shit literally okay. On the internet. But I just really wanna caution that we know so little.  It’s an organ we right. We only discovered it 20 years ago, and it’s not like our brain or our heart that you can see when you cut the body open. It’s literally been invisible, and so it’s [00:43:00] also. What makes us individually resilient? I love it because it’s a very empowering paradigm to introduce to patients and providers because each person has the ability to adapt in our individual and everything we think we know about standards.  Right. And algorithm medicine. This is where it diverts. And this is why some people respond to some things and some people respond to others. And so we know nothing except that we know we’re all special and unique. And you have to be your own scientist in everything you’re approaching, whether it’s herbs or diet or supplements or whatever.  And I really like that. That’s. A way for us to frame that individuality without making people feel crazy. ’cause they’re like, you know what? It’s like, why doesn’t this thing that worked for everybody else work for me?

Dr. Weitz: So let’s say you are a [00:44:00] clinician and you decide to use the antibiotic on a patient who’s maybe got IBD and is having an acute flare.  What would you think would be. A reasonable dosage that if you wanted to push it a little bit, that you could go up to?

Dr. McBeth: Yeah. I mean, so one capsule is loosely equivalent to a half a gram of pooled stool, but a half a gram of stool.

Dr. Weitz: If they threw an FMT, how much stool are you getting?

Dr. McBeth: 50 grams, 25 gram to 50 grams.  

Dr. Weitz: Wow. Okay. So that would be a hundred capsules, right?

Dr. McBeth: And I think part of the reason I really like the antibiotic and I liked making it, is it’s very much a low dose, very safe, gentle nudge. I think it’s totally fine to, to taper up patients in acute phase. I had food poisoning yesterday and I just like pop a handful kinda.  Okay. But I’ve been doing that for a long time. Right. And I’m [00:45:00] comfortable with that. But starting with one and then going to like two, twice a day, you know, or up to. Two, three times a day. I don’t think you need a lot more. You definitely don’t need a hundred or 30 or whatever. I don’t think it’s gonna hurt you, but I just don’t think it’s necessary and it’s not cost effective.

But I, again, individual people, it’s reasonable to sort of test out that tapering up and down and sort of see where in acute phase people respond, verse. At a baseline, kind of a maintenance or you know, honestly, what’s interesting and we didn’t expect is sometimes this really helps people, but then it kind of like the effect of it kind of tapers off and it actually works better if you post dose it.  So you give people whatever they tolerate, two, four caps a day for three or four days, and then you wait a week and then you do it again. And so everybody’s a little bit different there too. [00:46:00]

Dr. Weitz: Interesting.

Dr. McBeth: Don’t ask me why we know nothing fascinating. It shouldn’t do anything. Right. Yeah. That was what I was told when I first started this, but it definitely seems to be a safe tool, a gentle tool to help people when they’re in a tough spot and other things don’t seem to be working.

Dr. Weitz: Right. Is there any smell or taste?

Dr. McBeth: I don’t think so. There’s like a, maybe a musky undertone. Okay. It’s not poopy. Right. Like we actually have just finished doing a very. Diligent, we’re gonna put like a desiccant pack that’s very non-toxic and very, you know, top of the line that has like a little bit of citrus or mint.  We’re deciding between those two just because it’s an IIC factor. People and you know, the other thing I tell people is if you’re anxious, you don’t know if you should take this. You’re uncertain. Don’t just don’t do it right. Don’t do it. Be, I like, we all have agency, so don’t be peer pressured, but.[00:47:00]  You know, email me and I’ll send you why I think it’s safe, if you want that information.

Dr. Weitz: Where can practitioners or patients find out about ordering it?

Dr. McBeth: Yeah, so we have a website thena.com. And

Dr. Weitz: can you spell Thaena?

Dr. McBeth: T-H-A-E-N-A. So it’s the Greek spelling.

Dr. Weitz: Oh, it’s the Greek spelling.

Dr. McBeth: Okay.  Yeah. ’cause microbes, and, you know. The domain was available if you spell it funny, you know. And yeah, and then we sell it through our website. And so there’s a provider wholesale cost, so I recommend definitely if you’re a provider, sign up, it’s half price, wholesale. And then direct to consumer. A 30 cap is 1 99.  And a 90 cap is 4 99. But also if you’re a patient of a provider, you get a URL and you get a discount. If you sign up for data tracking with our Chloe app and contribute, you get 30% off. So we have lots of ways to incentivize and try to make it accessible, but still maintain the integrity of the science and the sourcing because, you know, these are really healthy people.  They’re hard to find. It’s not simple to find a vaginally born, breastfed, fully organic. Never been sick. 

Dr. Weitz: Oh wait, you know, I don’t think we really explained that. So the patients that are donating the stool have to meet certain criteria.

Dr. McBeth: Yeah. Our super poopers, we’ve been recruiting them for poopers a long time.

Dr. Weitz: Okay. Okay. So go through real quickly what exactly characteristics they have to meet for their poop to qualify.

Dr. McBeth: Yeah, so they’re, they’ve never been chronically ill, they’ve never been prescribed, you know, Adderall or antidepressants or heart disease medicine, or, you know, they’ve never had cancer, they’ve never had autoimmune disease.  They’ve never really been sick besides like the flu or acute stuff. That’s normal. They’ve had [00:49:00] less than five antibiotics in rounds in their lifetime. They were vaginally born, breastfed. We do a very exhaustive interview about their environmental risks. We talk to them about what their job was and how they grew up and what food they ate as kids and did they have pets and you know, everything we can think of that we know about the microbiome.  And then we have them do a diet diary and we look at their food and we really care that they have good quality ingredients and not ultra processed foods, that they’re healthy in exercise. And their BMI is in a good range and they’ve never yo-yo dieted and they have a good relationship with food and they’re not allergic to anything.  And then we do theorem and stool testing for infectious disease and we back check them on, you know, all the important things.

Dr. Weitz: Wow. So this is good poop.

Dr. McBeth: Yeah. I mean, as good as you can get in America in 2025.

Dr. Weitz: Alright. Thank you so much for joining us today.

Dr. McBeth: Yeah. Thank you for having me. It was lovely.

____________________________________________________________________________________________________________________________________

Dr. Weitz: Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would very much appreciate it if you could go to Apple Podcast or Spotify and give us a five star ratings and review. As you may know. I continue to accept a limited number of new patients per month for functional medicine.  If you would like help overcoming a gut or other chronic health condition and want to prevent chronic problems and wanna promote longevity. Please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111 and we can set you up for a consultation for functional medicine and I will talk to everybody next week.