0:01 Well, thank you everyone for joining us. My name is Ryan Burns, and I am going to be talking today about psychobiotics and microbiomes that make up us as humans. I'm going to start with a quick further introduction, but also some disclaimers, and then we'll get into the science of the gut to kind of provide us with a grounding for an individual case study, that we'll review, which comes in the form of my partner's experience with kind of using psychobiotics. And then we'll kind of take a look from there at the future of psychobiotics and how I see them fitting into healthcare as we know it, and we'll have time for some Q&A.
1:06 So, for starters, I am a data scientist. I also have type 1 diabetes, just diagnosed at age 3 and am on Fort Collins' Disability Advisory Board, ensuring that we've got an accessible city. And then am a partner and caregiver for my wife when she needs it. She has Bipolar Disorder 2, and so we'll get to dive into that a bit more. Now, as kind of a factor of having to be diagnosed at age 3 with Type 1, I'm very comfortable talking about medical conditions, and kind of that is a component of my individual experience. I have the consent of my partner to talk about her personal journey and medical experience as well, but I understand that not everyone is as comfortable, so I just wanted to kind of give that as a foundation for the rest of the talk.
2:07 I also want to say what I am not, which is a doctor or a medical professional, so we're going to be diving into some topics that I've been forced to become familiar with, and I can stick to the script in terms of what I've researched, but I can't give you too far. I would be interested in a show of hands if there are any biologists or microbiologists who might be able to help with pronunciation? If not, I searched ahead of time. Okay, okay, perfect. So, there will be some discussion about the bacteria, bacterial phyla. If you've got a correction, throw it my way, I'll point in your direction, so I appreciate that.
3:02 So let's dive into the science. So, human microbiomes, we contain roughly 57% microbial cells as compared to only 43% of human cells if we're looking at kind of the makeup of us as an individual. So our human cells are outnumbered, fortunately. I mean, fortunately, I guess, microbial cells are much smaller than human cells. And so, in terms of weight, that might not necessarily be the case. But when we look at kind of the human body and what has a cellular bacterial biome, if it's exposed, it has one. And so, we've got this list here, skin, there's an oral microbiome, the lungs and the gut, there's an anal microbiome.
3:59 So, inside and out, top to bottom, if you've got it and it's exposed to the world, it's covered in bacteria whether you like it or not. And so, when we look at the science of kind of psychobiotics, which would be, you know, thinking about how we might be able to use bacteria to affect how our experience is, you know, in a mental way, treating psychiatric illnesses, the gut microbiome is especially critical. The gut microbiota weighs roughly 2 to 3 pounds, which is roughly equal to the actual weight of the human brain. And so, when we have the bacteria in our gut, they're producing, through fermentation, they're ingesting fiber and producing short-chain fatty acids, like acetate, propionate, and butyrate.
5:12 They're also producing neurotransmitters, and when we think of neurotransmitters, I, at least, was initially kind of taught, you know, how they're interacting with the brain. But when we look at the gut, there's 90-95% of the body's total serotonin being produced in the gut, as well as 50% of the body's total serotonin. Now, that's not to say that that's serotonin is necessarily being flowing into the brain. You've got a blood brain barrier that is going to affect whether or not those neurotransmitters are maybe up there. But there are systems that the body has to communicate that kind of make up the gut-brain axis. So, that gut-brain axis is facilitated by the vagus nerve. Vagus.
6:06 Vagus. Vagus. Did I get that right? Okay. The vagal nerve endings, they don't cross into the gut, but they receive the chemical signals that are produced by our gut microbes. And so, 80% of those vagus... Vagus. Vagus. Did I say that wrong again? No. Okay. Vagus. Okay. The vagus nerve fibers are sensing from upwards. Only 20% of the communications that are running through that nerve are going out from the brain. So, this nerve structure is sensing what our body is receiving in the gut, what the gut is producing. It's sensing those neurotransmitters, and is responding and feeding that back up to the brain.
7:09 In addition, the gut has 70-80% of our immune system. So, the gut-associated lymphoid tissue is the gastrointestinal immune network. So, that's housing roughly 78% of the body's immune cells. and that protects against intestinal pathogens while training the immune system to tolerate harmless food and beneficial gut microbes. So, regulatory T-cells act as the immune system's essential breaks, suppressing excessive inflammation and preventing auto-reactive immune cells from attacking the body's own healthy tissues. So, when those regulatory T-cells are developed, they're developed using those short-chain fatty acids that are produced in the gut. When we see the gut start to enter into a state of dysbiosis, that's when we start to see things really go awry.
8:09 And that's, you know, what research is starting to find become more and more relevant to the induction of the autoimmune conditions that often still are, we're kind of searching for a root cause reason for why they're developed. So, Type-1 Diabetes is a good example of an autoimmune disease where the beta cells in the pancreas that produce insulin have been attacked by the immune system. Those cells are no longer, you know, killed off and not able to produce insulin. And so, Type-1 diabetes have to introduce exogenous insulin via needle or insulin pump to continue to have that system function. So, this is my wife, Monica. She is an artist and a big fan of cats.
9:10 We have two cats. I was only able to get a good, we only got one that's particularly photogenic. So, that's Angel. But the rest of the pictures, you'll see Monica. She enjoys the color, she enjoys the glitter, and is constantly cheering on the latest in Duke basketball team. So, she, as I mentioned, has a diagnosis of Bipolar 2, which is a fairly complex illness. It's dominated by major depression with occasional bouts of hypomania, which is different from mania, in that hypomania doesn't have a necessary impact on direct day-to-day function. And it is typically experienced in kind of a four-day window.
10:12 Mania can include full-blown psychosis, visions, requiring hospitalization and can last for seven days or more. So, when differentiating between Bipolar 1 and Bipolar 2, we've only started to recently do that, as of 1994. And the kind of misconception that is often run into is that Bipolar 2 is milder because it doesn't necessarily result in hospitalization. But that's not necessarily correct. And those depressive episodes can often lead to some of the issues with regards to suicide attempts that are noted at the bottom of the slide there. So, Monica was diagnosed in 2020.
11:13 She had a job loss due to COVID, as many of us did. She was working in the hotel industry. So, that's about how it went. And in July, we were living in Washington, D.C. And she said, you mentioned you liked the idea of living in Colorado. Let's drop the lease and go. At the time, I would not have identified it as a hypomania decision. In retrospect, dropping your lease and moving across the country is a decent example of a decision that might involve some level of hypomania. And so, she was diagnosed officially in September of 2020. And for the longest time, we tried every sort of pharmaceutical intervention that was available.
12:07 Atypical antipsychotics and mood stabilizers are kind of the go-to. And she also eventually developed Type-2 Diabetes, which is a common side effect that comes along with some of the atypical antipsychotics that are used to treat bipolar disorder, and ultimately that really kind of reflects how bipolar disorder is interacting very intimately with the insulin resistance that is ultimately mediated by the gut. And so, we're actually seeing some emerging research around GLP-1s that are being used to treat Type-2 Diabetes that have entered into the market in the last year or so. Also being used as a potential tool for helping reduce the symptoms of Bipolar 2 Disorder. In 2023 or 2024, while we were working through a long list of pharmaceuticals, trying one at a time without significant gains, in part because they're looking to treat symptoms rather than sort of root cause.
13:24 I came across the story of Jane Dudley, who's a woman in Australia who managed to treat her Bipolar 1 Disorder with a Fecal Matter Transplant. And so, she had her partner provide her with the stool samples via enema and saw a complete reduction of her symptoms. Waited long enough years from when she first started testing it in 2016 to say, I've been cured because no one wants to be the person that claims they were cured and never finds themselves back in the hospital. But, she attributes her success largely to the very stringent diet that she's followed since. And so, there's a great book that just came out, that's featured here that goes through and captures her case study written from the doctor that was partnering with her to help with her treatment.
14:30 So, I found the video of Jane towards the end of 2025. And if we look back very briefly at this timeline, I guess it was at December 2025 when I found her story. Or I guess, I think I found her story in 2024, but it wasn't until 2025 when we'd tried every possible option. And the idea of something as dramatic as a Fecal Matter Transplant was under consideration. Now, the tricky part of obtaining a Fecal Matter Transplant was that as a Type-1 Diabetic, I wouldn't have the opportunity to provide a stool sample in the same way that Jane's partner had, and since having conducted that Fecal Matter Transplant, she's done a lot more research, having gone from sick to well, and since has done a lot of research and realized that there are a lot of safety considerations to take into account.
15:44 just because of the immunity that goes on in the gut, if I were to provide a Fecal Matter Transplant to anyone, there's a strong likelihood that I would transmit Type-1 Diabetes to a recipient. So, we're going to dive into the data next. So, all the data that we're going to see next was collected with the eMoods App. It's a common app for treating a Bipolar Disorder. So, all kind of first-hand accounts. I have gone backwards as a data scientist who's nerding out and kind of validated her self-reporting on the sleep hours with her Fitbit. It lines up pretty well, so I kind of accept the numbers as they're presented.
16:48 So, we started her down the Fecal Matter Transplant having been able to find an online provider of screened stool in February. And these are the results that we see of her reported depressed mood score. So, if you look back at the depressed mood, the 0 would be none, 4 would be severe, or 0 would be 1, 4 would be severe. You can see how she's trended. After the last FMT in April, she stopped all bipolar medications for that period of time. So, to be completely transparent, I think we've also come away with a number of learnings around diet and did not adhere to a level of diet that was necessary to follow and contribute to the retention of a healthy gut.
18:04 And so, we've seen just in the last month her re-enter into dysbiosis. And I thought it would be disingenuous to not share that as well. So, she's currently not doing very well. We're not leaving her hanging. So, you can see we've acquired new stool. The first three lines there are older stool samples that were first ordered in April. There's no, there's no expiration date here. You know, we have a manual freezer that we're setting. They arrive freeze-dried. But, whether the bacteria is able to survive from April to August is... I can't, I have no lab to send that off to. So, she took what we had left.
18:58 We got a new order in today, or yesterday, that she's taken. And she's in on bed right now. So, here's her elevated mood trend. Again, you see the science, I believe, is valid. The connection between the gut and the brain, The gut-brain axis is one that's continuing to see research continue to emphasize the value of the microbiome in affecting how one feels on a day-to-day basis. And then, in terms of not just reported mood, but an actual measured variable, here's her hours slept on a day-to-day basis on a 10-day moving average. So, in January, she was in bed some days up to 20 hours a day.
19:58 And then, for that period after that April FMT, she's averaging six hours a day in bed. I think the other kind of interesting factor here is, as she was dipping towards these below five-hour days, we did have some concern around hypomania. And we ultimately chose to restart her on one of her antipsychotic medications, just from a safety perspective. So, I've been in contact with Jane Dudley, through the power of the internet. It's been really exciting. Just contacted her on Instagram. She's a very brave woman. She said she remained on her medications for the first year after having participated in a Fecal Matter Transplant. What's interesting though, and having done more research just in the last month, she, I would suspect, was on Lithium, which is a common treatment for Bipolar 1 Disorder.
20:59 Monica has a Abilify, which is a common treatment for, is an antipsychotic treatment for Bipolar Disorder 2. The difference between these two is that, while they're both designed to be mood stabilizers in their effect, Lithium has been shown to have a neutral effect on the gut microbiome. But now that we have the ability to recognize the value of the gut microbiome in determining psychiatric health, they're starting to realize that atypical antipsychotics can actually cause bacterial dysbiosis. And so I do think that it's possible that the restarting of the Abilify instead of Lithium may have been a factor there as well. But also our diet was not the best.
21:52 So that's absolutely something that we're going to work on. So in terms of the bacterial makeup of the gut, here are the phyla that typically make up the gut. And what's interesting is that the gut changes over time. And so what we see present in the gut is not going to be the same when we're first born. It generally continues to change until about age 3 to 5, where it starts to stabilize to what we see for a healthy adult. But there are continued to be changes throughout the teenager years as well. So we did take a single stool sample in January prior to starting the FMT.
22:50 And you can see the level of dysbiosis that she was exhibiting. And this was the stool sample that was taken immediately following the April FMT. So in terms of kind of actual verified lab work, we do see that the gut was rapidly different. And even with the Firmicutes, you know, at 75% of what a healthy adult might want to see in terms of the relative abundance within the gut, she felt like she had a new lease on life. So we do aim to, especially with this next round, add additional supplements that can cause short chain fatty acids to be directly produced and help drive the engraftment of the Fecal Matter Transplant.
23:49 So hopefully get back to that adult kind of bacterial composition. But the science is all there. And so even while she struggles today, knowing that there is a possibility of a kind of path forward that has been validated as a potential treatment towards the root cause of treating Bipolar Disorder is something that is driving her on a day-to-day basis while it wasn't necessarily something that we could rely on factually or knew and had experienced in January. So I'm going to try and be brief because I know I'm running over. There is a huge amount of opportunity for Fecal Matter Transplants. Recognizing the safety considerations that come with kind of basically accepting an entire new biome from someone else into your gut.
24:56 I look at Type-1 Diabetes as an example where 12 months after having initially been diagnosed, patients that received a Fecal Matter Transplant showed continuous beta cell production. And if I think about the fact that the immune system sits 70-80% within the gut, I think that makes sense. And so I think there's a lot of opportunity for autoimmune treatments and mental health treatments to continue to benefit from Fecal Matter Transplants. Additionally, when we look at phyla, there's a huge number of species that make out each of those. So when we think about the domain phyla all the way down to species, there's a lot of differentiation between species and the larger group of phyla.
25:56 And so there is research that's been recently being done that targets specific species that are associated with specific conditions. And so I do think that we'll continue to see targeted bacterial treatments in the near future. I've mentioned safety, healthcare cost and coverage obviously, would be glad to talk about with anyone any day. Three-year-old me did not have a choice that led to my needing insurance on a day-to-day basis. But we're very fortunate that I'm already hitting my max out-of-pocket every year. So I don't expect every person with Bipolar Disorder to have been able to try every pharmaceutical before they get to the point where they say what next.
26:53 But Monica was, you know, we were lucky to have each other. And lucky that I was able to be employed for that time. And I think there are a couple of other challenges. Obviously, there are temporal variations in the gut. I think that dietary and environmental impacts. When we look at the rates of obesity in America, and rates of Type-2 diabetes in America, and then we look at Western-style diets and how they interact with bacterial colonies, I think we face an uphill road. And so there are challenges there as well that we will have to overcome. But there's not, at least for Monica and I, not really a choice, so we're going to have to figure it out.
27:50 The Psychobiotic Revolution is available in Fort Collins libraries. The Gut Mood Solution is not. But if you're interested in getting it, I have submitted a request for them to purchase it. If you submit a request for them to purchase it as well, I think that'd be great. It's only been out for less than a year, so, and came out of Australia. They're a great library. Happy to continue the conversation. I think that I would not be here having had the last three months prior to this month, having been able to have my wife back, if it weren't for the help of Jane Dudley and her bravery in speaking to her experience and sharing her path, despite the potential safety risks that are accompanied with Fecal Matter Transplants.
28:51 At the end of the day, there are people who are facing a situation where they have to decide what they need to do to be able to continue to go on. And so I would not be here without her, but also would love to continue to be a beacon that can share more information. There's a more research coming out every day on the gut microbiome, and how it can impact mental health. And so I hope that anyone interested in discussing will continue to reach out to me. I have a Google Notebook that is hosting all of the research that I'm finding as I continue to read. Are there any questions? I'm sure.
29:54 Recognizing that I can only generally speak to most of the science. Anyone, and I'll be really quick. I saw your hand first. I have two and I'll be really quick. So you used the term dysbiosis a couple of times. Could you just like speak to that, what defines it, what it is? Yes. So when you look at, so here you see kind of healthy as well as unhealthy. I guess, so one thing that I neglected to mention, what caught Jane's story that put the pieces together for me was that reaching back beyond Monica's loss of a job, in 2019 she had three rounds of antibiotic treatments due to a recurring lung infection, which ultimately I realized nuked her gut. And so gut dysbiosis would be where the presentation of the diversity of the gut is not at the place that you want it to be.
30:57 There might be bacterial species missing. There might be bacterial pathogens present. Yeah, this is unrelated, but in terms of a Fecal Transplant candidate, is there like an analogy to blood typing? Is there a universal donor? What goes into qualifying a good or a bad fecal matter transplanter? Yes. So if you're looking for a slender or athletic body type with no health conditions, no current or past chronic gastrointestinal disease, autoimmune disease, asthma, diabetes, metabolic syndrome, body disorder, overweight or obesity, cancer, infectious disease. At that point, they do full genome sequencing of the gut. And then after that, they're going to be testing for HIV, syphilis, viral hepatitis, H. pylori, C. diff, and other parasites. And they should be screened every six months and should not be having used any antibiotics in the last six months.
32:01 So it's a very big, it's a very rigorous screening. Yeah. Awesome. Thank you. Okay. In trying to keep the answer as short as possible, because I suspect this could be a very long answer. You had mentioned some dietary behavior, dietary actions that you think negatively impacted the results and led to her having to go back on medication. What would you say would be the dietary actions that would have been recommended to try to keep that going? Yes. So the, so more fiber in general is, we all need as Americans. The fiber is being used by bacteria to fuel fermentation. Then, we have a lot of high fat, specifically animal-based high fat, as well as high sugars. How that translates into recipes, I'm still trying to figure out to a degree.
33:05 But, I recently became a big fan of kefir, I'm trying kimchi, looking at other sources of fermentation, and kind of trying to continue to learn how bacteria interacts with us in different cases. Yes. My question is what home test she's using. So she first used the Thorne's gut test, and then they pulled it from the market a week later. So we actually had to use two separate providers, which was really frustrating to compare those two tests. The second one, that is still available, was through Jona, J-O-N-A. And, again, I will say, these were nice to have, but we wanted to be able to know what the science worked.
33:59 But they were, I think, $400 out of pocket. So, once we do, I won't be ordering them again. We ordered the FMT again, now that we know that it works. We have a question. You mentioned supplements, I think, that help fuel the gut. Were those helpful? We haven't seen, we're still looking at results. Yeah. I do think continuing the conversation will probably involve putting a website together like Jane did at some point. So, I think we're recording. I'll be sure to update the video with the website once it's available. Yeah.
34:54 I was curious about diet around the world. What effect do you, in your research, if you came across different incidence rates and prevalence rates of the use of FMT or the incidence of mental health as related to diet, for example, a lot of Eastern diets, it seems like a lot of people eat Fermented foods that result in pre-biotic, pro-biotic, sort of cultures versus our diet, which is more artificial. Have you found any division or any changes in the data in terms of how it affects people and the rates of mental health in those places? Um, not exactly at the, like, outside of the United States. If I do look at bipolar for the United States, our incidence is five times greater than we're seeing in the rest of the world.
35:49 And I don't think anyone. That's what's reported, so. Yeah. Yeah. With what's reported. Yes. Um, and so, I do think that a lot of autoimmune conditions like obesity, but also mental health conditions like Bipolar Disorder are being shown to be much more prevalent in the United States than elsewhere in the world. And diet is an explanatory factor if we're looking for correlating variables. Alright? Yeah? Thank you.