ResearchSpeak & ClinicSpeak the gut microbiome and MS

Are you considering a faecal transplant? Don’t! Stop and think. #ClinicSpeak #ResearchSpeak #MSBlog #MSResearch

“Chicken or Egg? The number of articles dedicated to the human microbiome is increasing exponentially. The microbes that live in our guts are being linked to almost every disease state including MS.”

“The review below is very timely and looks at the evidence supporting a role of the gut microbiome in the pathogenesis of multiple sclerosis. As this topic is so important I will invite Ellen Mowry to do a guest post for the blog on this issue and the role of diet in managing MS.”

“We already have a well describe association between gut parasites and a low incidence of MS, which has led to trials of worm therapy in MS. The latter is a true experiment and is testing whether or not infection with a parasitic worm reduces MS disease activity. More recently it has been suggested that changes in the gut micobiome are an important risk factor for developing MS. Some have hypothesised that altering our gut microbiomes, using antibiotics followed by probiotics and/or faecal transplant from ‘healthy donors’ may lead to better control of MS disease activity. Before accepting this as fact you have to realise that developing MS may in itself change the microbiome and not the other way around; in statistical speak we call this reverse causation. Therefore a lot more research needs to be done on the microbiome before anyone can claim causation. The animal studies help, but they are what they are, just animal studies! I say this because one of my patients has already asked me what I think about faecal transplantation as a treatment for MS? This patient was considering travelling to Brisbane, Australia, to undergo the procedure in a private clinic. My comment was that unless the faecal transplantation was being done as part of a well-controlled randomised study with ethics approval they should not be having this procedure. Similarly, if it is proper research they should not have to pay to participate in the study. We are very concerned about ‘faecal transplantation’ becoming the next CCSVI with clinics offering an unproven therapy at great cost to desperate MSers and their families.”

Glenn & Mowry. Emerging Concepts on the Gut Microbiome and Multiple Sclerosis. J Interferon Cytokine Res. 2016 May 4.

Microbiota of the human body perform fundamental tasks that contribute to normal development, health, and homeostasis and are intimately associated with numerous organ systems, including the gut. Microbes begin gut inhabitance immediately following birth and promote proper gut epithelial construction and function, metabolism and nutrition, and immune system development. Inappropriate immune recognition of self-tissue can lead to autoimmune disease, including conditions such as multiple sclerosis (MS), in which the immune system recognizes and attacks central nervous system tissue. Preclinical studies have demonstrated a requirement of gut microbiota for neuroinflammatory autoimmune disease in animal models, and a growing number of clinical investigations are finding associations between MS status and the composition of the gut microbiota. In this review, we examine current undertakings into better understanding the role of gut bacteria and their phages in MS development, review associations of the gut microbiota makeup and MS, and discuss potential mechanisms by which the gut microbiota may be manipulated for therapeutic benefit.

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.


  • Everything must be duly proven, because unfortunately there is much opportunism on the other people's grief, but perhaps the first step to be taken is to improve the diet guided by a dietitian or nutrition specialist…

  • I believe a good diet promotes good gut bacteria. Fiber plays a very important role. From my own personal experience, my symptoms are much better when I eat a high fiber diet and stick to it for a long stretch of time. Once I start slacking on fiber, my symptoms will start to worsen.

    Btw, I am excited about a post from Ellen Mowry. I have seen some of her interviews and she always has interesting, useful and practical information.

  • Faecal transplantation? Ummm… No. I dont think I'd be up for it even if it were poopular… I mean popular.

    I cant imagine people doing this. Let me rephrase that. I cant vision people doing this.

    Butt! If I did HAVE to have the procedure (?) done then I want the raw materials (Ha!) to come from someone very healthy and very wealthy. Never know, might be some other goodies in there I was not blessed with! Then I could take my good fortune and give it to others.

    Then when I am asked, "Hey Cynthia, You had this done! Your feeling so much better you say and wealthy too! Whats the poop on that?" I can let them know to be very selective in raw material selection (ewww…).

  • I asked my neuro about this treatment and he just laughed in my face. However, my question wasn't about having it, my question was about whether there were any plans for proper clinical trials. His response was along the lines that clinical trials are only conducted on proper scientific theories so I was interested in the 'more research needed' comment – is this treatment seen as being 'reasonable' enough to even do research?

  • Just makes ya' wonder WHERE the concepts of these sorts of things are coming from?

    All seems like plumbing. CCSVI plumbing. Hydrogen rich water? Umm… plumbing. Faecal clean out! Err… plumbing. Am I missing any?

    Research based on "Lets just try this against MS" does not make sense.

    Gut Microbiome in its own right must be ever ever ever so complex with billions of various critters scurrying about interacting. How is science to even consider really going at microbiota in a serious fashion without at least a well understood concept of that complexity?

    If one were to ask "How much do we think science knows about it?" the response would probably be "A great deal." But when one considers the enormous interactions, complexities, differences from one peep to another peep it has to be more complex than that of the brain.

    We dont understand signaling at anything but a rudimentary fashion from what I have read. That is to say, "the millions? billions? of electrical potentials running throughout the brain in a given second. We have the basics down but when it comes to the conscience thought of me typing this out and all that comes with that… The thought, the motor actions, reading it back as I go, while breathing and listening and and and… Its mind boggling in complexity.

    Gut microbiome I would think is probably more complex as billions of lil' gizzards do their things.

    Since all those lil' critters are surely critical, foundational more than likely towards buckets of human function something such as Faecal transplantation might well be downright hazardous? Yes?

    One might(?) assume that a individuals microbiome is specialized towards that person? Surely more unique than a fingerprint. Good bacteria, bad bacteria, viral agent(?) perhaps. I could write a book on my questions alone in relation to this science.

    All I can do is speculate of course that this is all too complex to even be considering any form of usage towards humans, MS aside. At least until such a point in time as perhaps 80% of the complex matters thereof are well understood, documented and vetted over and over by multiple research overlapping studies.

    Call me a worry-wort but this is well the things that incurable new disease might be made of? Its well known bacteria, viral agents and then some happily migrate some across species. So it seems rather well… irresponsible to even consider something like faecal transplant whether thoughts are anecdotal or real statistical potentials arise.

    One of the things science as it continues to move ahead at breakneck speed seems to be forgetting more and more is "Just because we can do or try something does not mean its a responsible act".

    The phrase in Jurassic Park comes to mind, "So consumed with whether we could that never thought about whether we should."

By Prof G



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