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Do Not Try This at Home – Josiah Zayner hacks his stomach

A colourful personality and one of the most recognized faces in biohacking, Josiah Zayner is the focus of the most recent edition of the New York TimesOp-Docs series. “Gut Hack” chronicles one man’s quest to alleviate his lifelong abdominal pain, bloating, and constipation by killing the bacteria in his stomach and replacing it with microorganisms gleaned from an ‘ideal’ donor. Zayner’s ‘taking his stomach into his own hands’ is of course done without the blessing medical system and sees him risk the transference of parasites, pathogens and blood-borne illnesses through the transplant of his donor’s fecal matter into his body. The documentation is handled with the objectivity you’d expect from the Times, and it is worth watching if only to see a) Zayner’s garage-based biolab (the mythology of the garage as ground zero for innovation is alive and well) and b) to find out if the biohacker’s microbiome gambit pays off.

Josia Zayner

  • Nicole

    Your body is jam-packed with microbes. In fact, there are more microbes in your body than there are human cells. These microorganisms exist in your nasal passages, on your skin, and in your gastrointestinal tract, and play a significant role in your daily life. Biohacker Dr. Josiah Zayner, an ex-NASA employee, had suffered from gastrointestinal digestion issues for much of his life, and had been told by doctors that it was untreatable. In an attempt to reduce the severity of gastrointestinal issues, Zayner had the idea to entirely replace his unique microbial flora with microbes from another carefully selected individual through an at-home fecal transplant. In doing so, he hoped to change the genetic make up of his flora, which in turn could prevent bacterial interactions that cause ulcers. His experimental progress was documented in the form of a mini documentary published online in the New York Times.
    The first step to attaining a new set of microbial flora was finding a donor. Because it was required to give skin microbial samples, nasal cavity swabs, and fecal matter samples to Zayner, it was particularly difficult to find a willing patron. Additionally, Zayner mentioned that it can be incredibly dangerous to do fecal matter transplants without doctor supervision—as pathogens, parasites, and even blood-borne diseases such as hepatitis can be easily transferred from donor to recipient. Regardless, he found a friend who would donate his bodily secretions under the condition of anonymity. After collecting the samples, Zayner had to find a place to conduct his experiment. He was unable to use his home as the site for the experiment because his microbes are present in high concentrations throughout the house. For this reason, he chose to stay in a hotel for the 72 hours needed to remain sterile from his own microbes. He took precaution to sterilize the room as best he could, and took only materials that would contain minimal amounts of his original microbial flora. Then, he ingested strong antibiotics that were meant to kill the entirety of the microbes in his body, and cleaned his skin and nasal passages thoroughly. After his body had been completely wiped of his original microbial flora, he made use of the donor samples. Donor skin samples were rubbed onto his skin, nasal secretions placed in his own nasal passages, and fecal matter ingested. This process was repeated multiple times over a 72-hour time frame to ensure that the microbes took root in his body. Following quarantine, Zayner went back to his daily activities. Theoretically, if the experiment was successful, the donor’s microbes would flourish in Zayner’s gastrointestinal tract, nasal passages, and on his skin, and his gastrointestinal issues would cease.
    In order to test if Zayner’s microbes were replaced with his donor’s microbial flora, genetic similarity of bodily samples was determined. Zayner collected bodily samples from himself before and after the experiment, and from the donor. These samples were genetically sequenced to determine sequence similarity. Zayner found that his microbial flora after the experiment was the most genetically similar to the donor feces in comparison with more than 60 random human fecal samples. This genetic sequencing validated that the experiment worked for Zayner, and that his digestive improvements could not be attributed solely to the placebo effect. However, Zayner also found that his skin and nasal microbial flora remained unchanged, though he had developed a sweet tooth, indicating that food preferences may be related to microbial flora present in the body.
    Zayner states in his work that “Sometimes there’s this thin line… between being crazy and being knowledgeable,” and while many people would argue that what he did was dangerous, it is undeniable that his experiment was an ingenious and innovative way to potentially solve a problem that doctors couldn’t. However, in my response I will argue that Zayner’ inventive strategy to cure gastrointestinal issues is not safely implementable as a feasible solution in the modern world.
    While introducing a person’s microbial flora into another person could be proven an effective way to treat gastrointestinal issues such as ulcers, there are too many strict regulations that would prevent it from becoming a normal treatment plan. Zayner’s success in eliminating his gastrointestinal issues is only one of many possible outcomes of do-it-yourself (DIY) fecal transplants—many of which are negative. Regardless of how effective at-home microbial flora transplants may be proven to be, the risks far outweigh the benefits in the eyes of professionals.
    Fecal transplants are only performed when hospital patients have little to no healthy microbes in their system to fight the bad bacteria. Donor fecal matter is usually taken from a person who lives in close proximity to the recipient and therefore would be more likely to have similar microbial flora. Because these recipients have compromised immune systems, it is vital to replace lacking microbial flora with microbes that the body is accustomed to, in order to prevent harmful side effects. Prior to transplant, fecal matter is thoroughly tested to ensure that it will not harm the recipient. By Zayner purposely removing his healthy bacteria from his gastrointestinal tract and inserting foreign, untested fecal matter into his system, he was putting himself at risk of acquiring much worse gastrointestinal issues than he had previously dealt with.
    In 2013, the FDA introduced fecal matter as a potential Investigational New Drug (IND) and a Biologic, but only physicians who already held an approved IND application would be able to perform the transplant (The Fecal Transplant Foundation). However, months later, the FDA reversed their position on fecal transplants, and now requires that qualified physicians must perform the transplant under a restrictive set of specific conditions. It is estimated that the success rate of treatment for recurrent C. diff. using fecal matter is well over 90%, even though less than 500 have been performed in the US since the 1950’s (The Fecal Transplant Foundation). With continued research on the benefits of fecal transplants, it is expected that the FDA will be swayed in favor of the use of thoroughly tested fecal matter as a potential cure for severe gastrointestinal issues.
    In addition to the FDA being generally against fecal transplants except for in specific cases, there are many health risks involved when the fecal matter is not meticulously tested. Fecal matter can contain parasites, pathogens, and blood-borne illnesses, some of which can be fatal. By Zayner not testing the donor fecal matter, or at least not making it explicitly clear that he did, he likely ingested some pathogenic microbes that did not have an extremely detrimental impact on him, but may have been fatal to others. By showing his readers one specific case, his own, in which the benefits outweighed the drawbacks, Zayner is encouraging unsafe DIY fecal transplants, which is not a practicable solution to gastrointestinal problems.
    While Zayner was inventive in trying a new approach to curing his own gastrointestinal issues, his methodology will not provide consistent or safe results for DIY-ers. Like Zayner, many Americans are frustrated with doctors for failing to address their gastrointestinal problems, and have recently begun performing unsafe fecal transplants at home. It has been estimated by Catherine Duff, executive director of The Fecal Transplant Foundation, that about 10,000 people performed a fecal transplant at home in the past year (The Fecal Transplant Foundation). With that number on the rise, it is essential that the FDA come up with a plan to ensure safe fecal transplant processes. To guarantee the safety of Americans and to prevent potentially harmful microbes from being spread, the FDA needs to work quickly to find solutions that meet the time-sensitive demand of those performing fecal transplants at home.