How Gut Bacteria Shape Your Brain, Immunity, and Mental Wellness | Dr. Sabine Hazan

[RUSH TRANSCRIPT BELOW] Is it possible that autism, Alzheimer’s, bipolar disorder, and other major health challenges might all be related to the gut?

That’s the question Dr. Sabine Hazan, a gastroenterologist and CEO of Progenabiome, has been probing for years.

The Food and Drug Administration recently approved the use of fecal transplants for research into the treatment of autism, and Dr. Hazan says this may open the door to real breakthroughs.

She hopes to compare the microbiomes of autistic children with their neurotypical siblings and see if fecal transplants can help treat autism. She’s already seen one remarkable case where restoring gut bacteria brought real improvements for a child with autism.

Can these findings be replicated on a larger scale?

During the COVID-19 pandemic, she observed that people who experienced the worst bouts of COVID-19 seemed to have significantly lower counts of a key microbe: bifidobacteria.

“Bifidobacteria is important in absorbing sugar. It’s important in your metabolism. It’s important in your energy drive,” Dr. Hazan says.

There are trillions of microbes in the gut, and scientists are only just starting to discover how this delicate balance of microbes impacts people’s health, immunity, and mental wellness, Dr. Hazan says.

There are “microbes that can kill us, but also microbes that can save us,” Dr. Hazan says.

“You will see, probably in 10 or 50 years from now, there will be a connection between cardiac disease and the microbiome. We will be possibly able to fix the heart by fixing the gut, because it all is connected,” Dr. Hazan says.

Views expressed in this video are opinions of the host and the guest, and do not necessarily reflect the views of The Epoch Times.

RUSH TRANSCRIPT

Jan Jekielek:

Dr. Sabine Hazan, such a pleasure to have you back on American Thought Leaders.

Dr. Sabine Hazan:

Thank you for having me.

Mr. Jekielek:

So there’s some news hot off the presses, very relevant to your work. We have the FDA approving familial fecal transplants for research purposes. I mean, this is kind of a game changer. And the only reason I know it’s a game changer is because we’ve talked in the past and have kept talking. And the other thing is you have this study where you helped some twins, autistic twins, get better. And so I want to talk about both these things and then the whole bigger picture. But what’s going on with this FDA approval now? How is that going to change everything?

Dr. Hazan:

It’s going to at least allow us to do the proper research. This is not a pharmaceutical product. This is using the stools of a healthy sibling in a kid that is autistic. And it is also looking at whether the kid that is neurotypical has the same microbes as the kid that has autism and therefore kind of decide if we want to use that or not. 

So this is going to be research that’s going to open some avenues, give us some answers about autism, hopefully, and also research that’s going to allow us to say, why isn’t it working if it’s not working? Why is one kid neurotypical and the other one autistic? To be able to compare, because kids share microbes, families share microbes, and so that’s kind of like, you know, what I want to see with this study.

Mr. Jekielek:

Well, so let’s break all this down. Okay, there are multiple elements here. You know, autism, it’s this multifactorial disease, as best as I understand it at the moment. And of course, HHS now has this deep interest in tackling it because the rates have been going up. And that’s kind of, I guess, incontrovertible at this point. The question is why? And this directly targets that. 

The other part that I think you’re speaking to here is that people are different. One-size-fits-all policies for medical care just don’t work. And this is one of the lessons we learned during the pandemic that you need to treat each patient individually when it comes to the microbiome, when it comes to their genetics, all sorts of things. So let’s unpack all this for me.

Dr. Hazan:

Yes. To unpack it, you have to go back to the history of what happened. Right. How did we get to this? What is the microbiome? How does the FDA look at the microbiome, etc.? So if you think about the microbiome, it’s basically microbes in your gut. We describe the microbiome of the gut, but there are microbes all around us. If anything, we’ve learned from COVID is the importance of microbes, microbes that can kill us, but also microbes that can save us. And the importance of gut health, which is really your immunity, is in the gut. So that’s the first thing. 

When I embarked on this, I started looking at fecal transplant because I come from a world of having done hundreds of clinical trials for pharma. And clinical trials for pharma basically brought me to the world of C. diff. C. diff, a bacteria that causes diarrhea in patients. They overdo it with antibiotics and then eventually acquire this bacteria that secretes toxins and then gives them diarrhea and could kill them. 

In 1957, Dr. Einsman said, I can’t fix my patients with antibiotics. I can’t seem to get rid of this bacteria; let me do two enemas of poop from a healthy so-called healthy person. Back then, we didn’t even know what constituted a healthy microbiome. We still don’t; we have some ideas, but we still don’t have it as a guideline of what a normal healthy microbiome looks like. 

So when you look at Dr. Einsman, he just took from a gut feeling, because that’s what medicine is. It’s an art. It’s bravery. It’s, I’m going to take stools from a person, put them in another, and he fixed those two patients. That was the first case. Those were the first two cases. 

From there, Dr. Tom Borody started looking at that and saying, wait a minute, there could be something there. And there could be something there for autism. There could be something there for Alzheimer’s. There could be something there for other diseases. And he took it to the next level, but he tried to show it for C. diff. 

The way it works in medicine is you have doctors writing abstracts, and they publish them, and they present them at the American College of Gastroenterology or these meetings. And then you’ve got, you know, 18,000 young brains from all over the country gathering, and they go around these posters, and they start looking at the data.

That data from Dr. Borody attracted the attention of a few doctors; Colleen Kelly at Brown University, Neil Stollman, who’s on the board of the American College of Gastroenterology, Sahil Khanna, who’s at Mayo Clinic, Zain Kassam, and Jessica Allegretti from Harvard. So all these young people were basically fascinated with poop, whether it’s their gut instinct that there’s something there or not, it was definitely interesting. 

For me, it started at a meeting probably about two or three decades ago; I can’t even remember. But Neil Stollman took me to a poster and he said, the future is in poop. And I said, please don’t make me play with that because I like my colons to be clean, and I don’t like to step into this. 

And sure enough, fast forward, you know, I had a doctor that was dying of C. diff. I was the girl that was bringing drugs to market for pharma. I was the girl that was enrolling patients for clinical trials. And I was well known for C. diff. In fact, they called me, pharma called me the queen of C. diff because I was really good at enrolling patients. 

And the way that I would enroll is I would call on my colleagues and say, look, before you do a fecal transplant, give me this patient. Let me try this new drug. It’s, you know, safer. Basically, the FDA is watching; it’s cleaner. You don’t have to do testing on the stool donors. And so I started enrolling a lot of patients. And when a doctor could not be fixed with the treatment or couldn’t be fixed with the clinical trial, I did a fecal transplant and that doctor survived. And that was the first time for me to kind of say, wow, there’s something to this, right? But I would still do fecal transplant only when the clinical trial would fail. 

Because to me, the simplest way is, look, you’re getting paid by pharma to do a clinical trial. You do the trial. The trial doesn’t work. You at least have a backup, and you could use the money that you made from pharma to test the patient’s stools. You can treat the patient because fecal transplant, colonoscopies are expensive. Anesthesia is expensive. Testing the stools of the donor is expensive. So this was not something that you could readily do. 

And so when fecal transplant started showing Alzheimer’s improved in an N of One for me, that’s when I really paid attention. And then it kind of became from there, you know, the studies of Dr. Adams. Dr. Adams was working with Dr. Borody, then I started working with Dr. Borody. We all united as doctors that played with poop to understand the microbiome a little bit better.  I didn’t really believe feces could help autism; I had to see it with my own eyes, and so I had to do that N of One with the FDA.

Mr. Jekielek:

I just wanted to kind of break this down for the uninitiated, right? I mean, basically, so with a fecal transplant, you know, you’re basically taking poop from one person and you’re giving it to another. Correct? It’s a messy business, right? It’s a messy business, but you’re taking sort of a healthy, what you believe to be a healthy poop. Right? And you’re giving it to someone who has a problem, and you would see it if it was an obvious, very clear problem and that there’s no drug that will help them. That’s how it started. That’s what you’re saying, right? 

Dr. Hazan:

That’s basically it. So the people that come to me are always the people that have tried seeing a lot of doctors, and they come to me for clinical trials, whether it’s for psoriasis, Alzheimer’s; they come to join a clinical trial. So we look at clinicaltrials.gov. If we find a trial, we contact the pharmaceutical company. We say, hey, we have a couple of patients for you. Can we embark on the trial and test those patients? So those are the people that come to me. C. diff, they came to me because they didn’t have the funds to pay for a fecal transplant or the county hospital was not able to pay for whatever reason. So that’s where we are.

Mr. Jekielek:

So explain that to me, though. So you were giving them a fecal transplant, or you were enrolling them in a trial, or both?

Dr. Hazan:

When I started for C. diff, I was treating patients. And if the treatment didn’t work, I would enroll them in a clinical trial. So I had multiple clinical trials that I was doing at all times. So I’ve been doing clinical trials for pharma for decades. And so when a C. diff clinical trial didn’t work, I would use the funds to pay for a fecal transplant to help the patient. 

Mr. Jekielek:

I see. Okay. I understand. Yes. Okay, very good. Then with N of One, meaning this one patient, you saw a marked improvement. 

Dr. Hazan:

Yes, in one instance. So when I was doing it for C. diff, the only way in America to do fecal transplant is for C. diff. So remember, from Dr. Einsman to now, it took 62 years for fecal transplant to be part of the guidelines because it needed clinical trials. We needed Zain Kassam to show the data that fecal transplant improves C. diff. 

From there, pharmaceutical companies started paying attention and saying, wait a minute, if it improves C. diff, maybe we can make a pill of poop for C. diff and bring it as a pharmaceutical trial. They would bring it to the FDA. The FDA would help them; together, they would bring out a poop pill, essentially. 

So when you look at it from the beginning, those two enemas to where we are right now, where it’s part of the guidelines, it’s part of the guidelines as fecal transplant. It’s not part of the guidelines as well. I’m going to use the product from pharma, but 62 years have gone by. So in this country, if you want to have fecal transplant for whatever condition, you want to try for Alzheimer’s, you want to try for MS, for Parkinson’s, you cannot do it unless you have C. diff. And so the guidelines are very clear on that.

Mr. Jekielek:

Well, until now.

Dr. Hazan:

Well, no, still you need FDA involvement. So that case of N of One, which most people, you know, don’t realize, took three and a half years to get approved by the FDA. Of course, COVID was in the midst of all that, where the FDA said, hold off on fecal transplant because we discovered COVID in the stools and therefore we could pass stools with COVID to the patient with the immunosuppressed or the autistic kid or whoever we use feces, right? 

My first N of One of fecal transplants was actually not for autism, but it was actually for metastatic mesothelioma. So this was a woman that was supposed to die within a week. And the family came and begged me to do a fecal transplant thinking that it could be a good adjunct to the drug Keytruda. And I said, well, let me look at it, but it needs FDA approval. So that case was pre-COVID and that took us 24 hours with the FDA to basically say, hey, no problem, go for it. 

But I still had to argue with the FDA to say, look, this woman’s dying. Frankly, if I show her how to blend her grandson’s poop, you have no data. I’m giving you the data, and I’m willing to do it and watch her. Well, this woman improved up to a certain point. I mean, she lived on for months and months when she should have died within a week.

What we learned from that case was that not only did her appetite improve with the implant, she was craving her grandson’s foods, and her appetite increased; her weight improved. So it was a great adjunct in a way, but it had to be done the right way because the FDA was right. This is poop you’re putting in an immunosuppressed patient. So the problem then happened is that she ended up being given antibiotics down the road, and that killed whatever I gave her in the transplant. 

But that was the beginning to see and say, this is a patient with terminal cancer that was supposed to die within a week, and she lived on for months and months, maybe because we optimized the gut while we gave her a drug to kill the tumor or suppress the tumor. That’s the direction I want to go with that. 

But from that to that N of One with autism, that was 2019 and we submitted the case, and then COVID came in the middle of it. And we had a hard time getting that approved because COVID was in the midst of it. So if I want this familial FMT [fecal microbiota transplantation] that’s approved right now, it literally is a breakthrough in a way or not a breakthrough because we haven’t done the research, but it’s going to be an important study to give us data on whether siblings that are neurotypical can be a good donor for the kid that’s autistic.

Mr. Jekielek:

Well, just as I understand, as you said, right, there’s just you simply couldn’t do these studies before.

Dr. Hazan:

Couldn’t do it. No. And what changed, I think, is this administration is a little bit more efficient in the processing of the paperwork. I’m the agent, and I thanked her. She went back and forth, like within three days gave me an answer. The last administration, we basically had, we gave the protocol, we gave the paperwork in, and it would take like a month before we got answers back. 

So I don’t know if the politics changed. I would hate to think politics have something to do with treating kids with autism because kids with autism affect both the Democrats and the Republicans and the independents. It affects all races. It affects all religions, boys and girls. So, you know, to make it a political agenda is really not okay. 

We need to think when you look at one in 12-and-a-half boys in California having autism, you have to pay attention. You got to put all hands on deck and say, what are we doing here? How do we do it? And this is an amazing study because this is not a pharmaceutical study where, you know, the price of the stock matters more than the price of a life. 

This is a physician-initiated IND (Investigational New Drug) that, basically, as a physician, I’m going to be looking at these kids, every single one of these kids, and say, why did it work on this kid? Why didn’t it work on that kid? And what can I do to that kid that it didn’t work? 

Because I’m not going to wait, you know, for something else. You know, for something else. You know, this is where it happens. It happens on the front line of clinical trials, where as a physician, you have the courage to try different things. And there are definitely a lot of different avenues for autism because there are different causes for autism. You know, like you said, it’s most likely multifactorial. I’m focusing on the microbiome and an answer with fecal transplant possibly. 

But what about the kid that doesn’t have a microbiome abnormality and has a neurological primary? Or what about the kid that has inflammatory bowel disease where his colonic mucosa is completely, you know, destroyed, and we need to fix that before we start implanting microbes? What about the kid that has a connection between the brain and the gut? What about the kid that has a genetic problem? You know, these are different ways to treat. 

So when you do clinical trials, and when I do clinical trials anyways, I do clinical trials for a pharmaceutical company to bring a product to market. The product either works or doesn’t work. And then the FDA says, OK, Dr. Hazan, the product works, we’re going to bring it to market, even if the product only gives you 20 percent success. But what happens to the 80 percent that didn’t succeed on that protocol? Who looks at that, right? 

So think about it, the pharmaceutical company, their job is, hey, let’s bring the drug to market, let’s make billions of money. But who’s looking at the 80 percent that didn’t succeed on the protocol? Nobody. This is going to be a great trial because it’s going to allow me as a physician, with my hat as a physician that has done hundreds of clinical trials for pharma, to say, OK, well, familial fecal transplant didn’t work. Let’s look at this trial. And let’s not give up on this kid, much like what I did with C. diff. 

I would first start with the guidelines, which is you give antibiotics. And then if the guidelines didn’t work, I would go to clinical trials because that’s what was available. And I would say, let me try ABC trial. And then if that didn’t work, I would go to fecal transplant, and fecal transplant, 99 percent of my patients improved with C. diff. So I think that’s the same attitude that I’m going to take with autism. 

I’m going to try the first; I’m going backwards now. I’m going with familial fecal transplant first, and if that doesn’t work, then I’m going to go to the clinical trials, and then I’m going to go to whatever else is being used that has improved these kids. Dr. Richard Frye has some amazing studies that he’s seen some kids improve. You know, we’re testing the microbiome before and after because we want to see what is it in kids with autism that is improving and what’s not improving.

Mr. Jekielek:

You know, we first met because you had been doing work around microbiome and COVID-19, the virus, and then also what happened after mRNA vaccination. And this had profound effects on the microbiome. And maybe you can kind of remind us of what you discovered. And maybe sort of bring us to the current stage. 

Dr. Hazan:

Yes. So remember, I was the girl that basically was doing clinical trials for pharma. And when COVID, and I was doing fecal transplant, and that N of one was in the process during COVID. And at the beginning of COVID, I looked at myself and I said, I have a portal with the FDA. I’m connected with all these brilliant minds, Dr. Borody, Dr. Stollman, so many brilliant minds. And I’m a physician on the front line of clinical trials. Surely I can figure it out, and I own a genetic sequencing lab that’s looking at the microbiome, and we have the possibility to look for COVID. 

The first thing that came to me during COVID was I bet you it’s in the stools. Why? Because we noticed when we were doing stool analysis that if you have a person that has nasal congestion and is growing a microbe in the nose or in the sinuses, you will find that microbe in the stools. If you have a patient that has pneumonia, H. influenza, you will see that H. influenza in the stools. 

Or a person with a kidney stone, or Klebsiella pneumonia, you will see that in the stools. People are shocked when I analyze their stools, and they don’t tell me they have a prostate problem. And I say, you have a prostate problem, don’t you? And they’re like, how do you know? Because I see the microbe that would be presenting prostatitis in their stools. 

Think about the colon. What is the colon? The colon is where all the waste ends up, right? And so you’ve got three parts to the colon. You’ve got the part that goes backwards, the motion of the colon goes backwards. That’s the cecum. And then you’ve got the transverse colon and the sigmoid, where basically the stools are just to be evacuated. It’s the process of evacuation, okay? 

So when you think about what we do when we do fecal transplants, we transplant microbes of a healthy person and we put it in a cecum for the best results because it’s backwards and it keeps it in there, right? The rest of the colon is really for the evacuation of the toxins. So think about eating a hamburger with E. coli. Too much E. coli, it’s in your system. Your body’s going to give you diarrhea because you’re flushing out that microbe that’s too much, right? 

Same thing when you ate some rice that stayed over the counter, and you have a bacteria called B. cereus, you’re vomiting that. It’s foreign to the body. It doesn’t recognize it. So it says, get out of here, right? So to me, the first thought was, wait a minute, immunity is in the gut. I know that the colon is where everything’s there. I bet you COVID is in the stools. 

So the first thing we did, the first samples that came to America, we were right there trying to collect the stools. So the first patients that had COVID that we intercepted, we already had their stools, and we started working a pipeline. And I even called Scott Jackson at the time because he was part of my biome squad. He used to work for the National Institute of Standards [NIST]. And I said, I bet you it’s in the stools. And he started looking and getting his team at NIST to look at the septic tanks. And that was all the brilliant work that was done from NIST at the septic tank level. 

But we were at the clinical level. We were taking patients that had COVID, doing a nasal swab positive, and we were finding COVID in the stools. We found COVID in the stools in 100 percent of patients that were positive nasal swabs. What we then ended up figuring out is COVID can persist in the stools. And what we also ended up figuring out was that some people were asymptomatic and had COVID in their stools, but yet never had symptoms. What was the difference between those people? The difference was their bifidobacteria.

Mr. Jekielek:

I’m going to jump in because I remember early in COVID, there was some anecdotal evidence. I think it might have even been from Korea initially that people that are eating kimchi, a lot of kimchi, are doing well or not catching COVID. And then I heard something similar about sauerkraut, which made me want to eat kimchi and sauerkraut, of course.

Dr. Hazan:

So that was my question at the beginning, right? Those anecdotal studies of kimchi and sauerkraut, because obviously you can talk to people that ate sauerkraut and still got COVID. What’s different between that population? Why is one person eating sauerkraut and kimchi fine and another person not, right? So that was my biggest question. 

That question led to me wanting to test, first of all, families, right? Because I’m a big family person, like we find the answers in the family. Because we’re all different, we all have a different microbiome, it’s easier to compare within the families, right? So you could see, we published the first case of a family, which was basically the kid had COVID, the other three didn’t have COVID, and yet they didn’t wear masks, they ate the same foods, the mom was taking care of her kid face to face, and never got COVID.Her two other kids never got COVID. 

The main difference between those three and the kid that had COVID was the absence of bifidobacteria. Not only bifidobacteria, there’s another bacteria called Faecalibacterium prausnitzii, and there’s an increase in bacteroides that happens and loss of diversity. So we noticed that, but we focused on bifidobacteria. Why did we focus on bifidobacteria?

Remember, we had the clinical data of the microbiome before COVID. We were analyzing stools before COVID. So we knew babies had a lot of bifidobacteria. I always spill the beans and then somebody’s listening somewhere else, and then they do the research and publish, which is fine. When I talked at the first microbiome meeting, I was saying bifidobacteria, focus on the bif. Why did I focus on bifidobacteria?

Because if you look at the bottles of probiotics, you turn the bottle and it says bifidobacteria. Now, in the olden days, scientists could make an experiment like the discovery of penicillin, where you essentially, as scientists, left this apple mildew next to a petri dish with a bacilli, and then the bacilli disappeared from the fungus of the apple, and there goes the discovery of penicillin, right?

So in the olden days, you could see all these things. Now there’s such a, because everything is about market and patents and business, there’s a lot of secrecy to research. There’s a lot of data that we don’t know. And sure enough, bifidobacteria are important in absorbing sugar. It’s important in your metabolism. It’s important in your energy drive. It’s important in, you know, making sure a person wakes up and, you know, in the morning and goes to work and is effective, right? 

So bifidobacteria is really an important microbe, and it’s that microbe that is present in newborns. So when you start looking at the bifidobacteria and you start looking at COVID, we noticed that 43 severe patients with COVID had zero bifidobacteria. I’m just going to focus on bifidobacteria, not the others, because there are some people that have zero bifidobacteria and never, I’m going to up this group of microbes to basically create a resilience, right? 

You think about your kids that, and that’s something we don’t really talk about, resilience, right? So you think about your kids that took a ton of antibiotics and they’re fine. They don’t have any problems. Why? Because their microbiome has adapted to increase other microbes to create that resilience, right? 

So again, when you look at the bifidobacteria in these 43 patients, zero. Then you look at your patients that were exposed but never got COVID, like that first family that I did, we noticed they had a lot of bifidobacteria. So bifidobacteria was really the beginning for me. I was like, I wonder if that’s the microbe I need to focus on to neutralize COVID, to suppress COVID. If I have a lot of good bifidobacteria, maybe I’ll be fine during COVID, right? 

There was a study from a newspaper in India about a woman who lived to be 117-years-old. They found that it was because she had bifidobacteria in her gut. For longevity, the longer you retain that bifidobacteria, the better it is. And it’s not a simple thing because people are like, what should I take? Should I take this probiotic? 

No, it’s not that straightforward. You have to figure out what is killing your bifidobacteria and what’s growing, right? It’s like having a field that just burnt and you’re trying to stop the fire, and you’re pouring gasoline and water, and you expect to grow some fruit trees. It’s not going to happen. You have to turn off the fire, stop the gasoline pouring, bring on the water and then turn the earth, replant and let it grow. 

It’s the same thing in the microbiome. You’re destroying a city. So when you destroy a city, expect complications from that. Expect disease to happen. And so that’s really my field to demonstrate that once you destroy a key group of microbes, you start the disease process. 

So what we discovered, this bifidobacteria was really the beginning. It was the beginning. And then when we looked at that kid with an N of One of autism, that we got approval after, you know, in the midst of COVID, and we discovered if I give him a neurotypical sibling that has a diversity, that has good resilient microbes that have, you know, allowed herself not to have autism, but yet the boy has autism, then that sibling might be the answer for that kid. 

And what we noticed with this sibling is that the kid had one group of microbes that the sibling didn’t have. So we picked that sibling. We didn’t pick the other ones because they had some of the same microbes as the kid with autism. Are they predisposed to going into autism? Who knows? But we picked that one sibling, and that one sibling became the donor. And what we discovered with that was that there was refloralrization. And the refloralrization process is really an engraftment of microbes to mimic, to look like the sibling, to look like the donor.

And one of the things we discovered was that bifidobacteria are increasing. Now, whether it was because we suppressed that toxic bacteria and allowed the gut to kind of rest and give it diversity, and therefore the good bacteria started flourishing. But that case was really the one that, first of all, made me say, I need to see more, because that was the miracle. I think what I saw during the pandemic was a bunch of miracles, from losing no one during the pandemic to still being standing and speaking to you today with all the controversy in my research. 

Because here I am, the girl that brought vaccines to market. And because I showed data that the messenger RNA killed the bifidobacteria, now I’m an anti-vaxxer. So the controversy has stopped the movement of research and science. And again, we need to stop with the controversy and say, let’s ask questions. That’s what science is all about. Science is about asking questions and pushing that narrative and saying it’s not the way it should be.

Mr. Jekielek:

And if I may just jump in, I mean, you discovered that the spike protein reduces bifidobacteria, really. 

Dr. Hazan:

Correct. So what we discovered with the vaccine is that it did kill the Bifidobacteria within a month, but it persisted in killing the bifidobacteria. People come to me every day with long COVID, and I take their history. And I go back and I say, so did you have COVID? Were you vaccinated? And they’ll say, yes, I was vaccinated. And I’ll say, were you vaccinated? Did you get COVID after the vaccine? They’ll say, yes, doctor. And I’ll ask, did you get COVID before the vaccine? They’ll say, no, I was fine before the vaccine. 

Then you have to start asking, did the vaccine kill their Bifidobacteria? In other words, they were fine. They had bifidobacteria in them. And then they started fighting the virus and they survived and therefore created their own little immunity, right? In a way, because immunity is the ability to get a piece of the microbe so that it recognizes the next microbe in the future, right? 

So in layman’s terms, you have to think of your body as a group of communities, a group of gangs or communities in your gut. And there’s one microbe that approaches, and there are some that resemble the microbe. And it’s like, hey, you’re part of the gang, you’re part of the family, you’re part of the community, come in, you’re non-dangerous. 

But if you see a microbe that’s a foreigner, the microbiome is on guard and saying, wait, foreigner, we don’t want it, reject, autoimmune process occurs, right? So that’s how I look at it anyways. I could be wrong, I could be right, but this is how I see the microbiome. So when you look at these patients and you say, the vaccine, you got the vaccine, you probably killed your bifidobacteria. Now your bifidobacteria is low; you got COVID.

So now it’s like a double whammy. You’re killing more bifidobacteria. And so these people, what happens with long COVID or these vaccine-injured, it depends on the timing because there are long COVID patients that never got vaccinated. They got spike injury. I think we need to rename all that to spike protein injury. You have to start thinking of, at what point did they kill their bifidobacteria? 

Because if you look at the long COVID or the vaccine-injured, the one—and we’re coming out with data on that—zero bifidobacteria, across the line. I mean, I’ve yet to find one person that is deemed long COVID or vaccine-injured that has bifidobacteria. So if they have zero bifidobacteria, I know, because I’ve been dealing with this for five years now, it’s very difficult once you’ve killed your microbiome to get back up. 

So these people are still at a state of loss of diversity, loss of immunity, poor immunity. And they’re also in a state—remember, bifidobacteria is important in absorbing sugar. So they’re not absorbing sugar. And that’s one microbe that they’ve lost. 

What about the microbe that helps break down calcium to get absorption of calcium? They’ve destroyed that as well, so they’re not absorbing calcium. What do you think happens at the cellular level in the mitochondria when you lack sugar and you lack calcium? You’re missing that energy, that Krebs cycle. Your mitochondria stops working. Therefore, the cell’s not doing what it’s supposed to do. Their energy level is down. 

So what happens at the microbiome level? Your good bacteria is down. Now you have space for bad microbes to come in. That’s your anxious patients, the people that can’t sleep, the people that have mast cell activation syndrome. So this is kind of like the process of how it happens. So long COVID is really a spike protein injury. But also, when you look at these cases, they have zero bifidobacteria, either from the treatment or the virus themselves or the spike protein. But also some of them have remaining COVID in their stools. So we need to pay attention to that.

Mr. Jekielek:

There were some problems also with sometimes there being endotoxin in the COVID genetic vaccines and so forth. So that would be another route where there could be damage and problems. So does that factor into what you’ve been looking at? 

Dr. Hazan:

There are a lot of different factors. There was a study from Kevin McKernan and Philip Buckhaults that basically showed contamination by SV40, right? That could be a possible mechanism of how this vaccine became a bifidophage too. Did it stimulate, you know, the ability to stimulate cancer cells, for example? We don’t know. That’s a whole new area. 

Mr. Jekielek:

So that’s the third thing, right? There’s the SV40, and then there’s also just the endotoxin. 

Dr. Hazan:

Yes, the E. coli and the plasmid. And then the nanoparticle too, the fact that it’s able to get absorbed.

Mr. Jekielek:

Right, that it penetrates basically all membranes.

Dr. Hazan:

Correct. So that makes it even more different. You know, like the whole idea, the reason I stepped into the pandemic at the beginning was really because there were so many red flags. You know, the messages from the media, the vaccine stays in the deltoid. Nothing stays in the deltoid. It’s not like there’s a little pocket there that’s sterile. You know, the muscles are connected to the nerves, which are connected to the blood vessels. Everything’s intertwined, you know. You can’t just put something in a blood vessel and expect it’s going to just stay there. And again, the blood vessel supplies the muscle. 

We tend to divide the medical field into different specialties that we forget that the gut is connected to blood vessels, by nerves, by lymph nodes, by lymphatics. It all circulates. So we can’t just think, well, it’s a gut problem. No, it’s a gut and a brain problem because they’re connected. And it’s not just a heart problem. They’re connected. We’re going to come out with—and you will see probably in 10 or 50 years from now, there will be a connection between cardiac disease and the microbiome. We will possibly be able to fix the heart by fixing the gut because it all is connected. It all moves. All these viruses are passing, moving.

Mr. Jekielek:

The toxins of these microbes, bacteria travel, you know, so that’s going to be the future. Are you aware of cases where, you know, we’ve been able to treat people with either vaccine injury or long COVID by fecal transplant?

Dr. Hazan:

That’s something that I possibly would bring. Although I think, you know, as I was pushing, you know, there are other ways to fix, you know, something that’s going to be coming in the future. You know, you always got to keep on top of the research, and research is a story that’s untold. It’s one experiment after another, after another, and you discover one thing and you move on to another thing. And then others kind of bring in their opinions and validate, verify, and reproduce what you’ve done, right? That gets you to keep moving further. Look, this case of familial FMT is going to be amazing. But in the time that I spent trying to get that approved by the FDA, which was five-and-a-half years after this protocol was approved, I had patients with autism that came to me; I had to do something. 

So there are things that you can do when you understand the microbiome that can modulate. So the whole process of refloralization is not just I’m taking stools from a healthy donor and putting them into the person. It’s really refloralization that I coined as bringing back the flora. However, you bring back the flora. There are cases that said, well, and I’m very linked with the whole autism community, right? Because I pay attention to everything.

One of the things was antifungals. Some parents swear by antifungals. There’s a woman that wrote a book and basically it’s about how she improved her kid who was nonverbal autistic. And now the kid is working as an engineer somewhere and basically graduated college, but she gave him antifungals. Now there are a lot of parents that listened to that case and tried antifungals, and their kid is still nonverbal. Why is that? Because that antifungal was probably the right solution for that kid’s microbiome. Maybe he had too much fungus in his microbiome and therefore the antifungal improved that. 

I’d like to work with this administration right now to kind of guide us better by looking at the microbiome. Pay attention to the microbes. Pay attention to what we’re doing before and after. Before you bring a drug to market, see what it’s doing to the microbiome, both short-term and long-term. You know, I think that’s where I want to bring pharma. People have said, oh, I’m shaking the beehive of pharma. 

I’m the girl who brought drugs to market for pharma for almost three decades, and my sister has brought Harvoni and ivermectin to market for pharma. We’re in the clinical trial business, my whole family. We’re three sisters. One is a dermatologist in New York. The other one was a pediatrician/clinical trial doctor. The pediatrician/clinical trial doctor did over 300 clinical trials for pharma and has brought many drugs to market. 

Why was it that pharma listened to us during all those clinical trials? Think about drugs like Remicade that made it to the market. Drugs like Repatha. I did the clinical trial on Repatha for cholesterol for Amgen that went to market. Why are we listened to when we bring a drug to market, and we’re not listened to when we’re saying, hey guys, pay attention to the microbiome? 

I’m not here to shake the beehive of pharma. I’m here to take the beehive and put it in a nice place so it can make me some nice honey. That’s why, because Rome, you’re destroying the gut; you’re destroying Rome. Rome was not built in one day, much like the gut is not going to be built in one day. And it was not built by one person. I’m not one person to restore the microbiome of humanity, but I’m one person who can be a little bit of a hurricane and work with multiple pharmaceutical companies like I’ve done in the past to say, let’s start looking at the microbiome, guys, because eventually, you’re going to be that patient.

Eventually, you’re going to come to me. How many executives from pharma have I treated as patients who have come to me because of my knowledge of clinical trials? You know, how many billionaires have I treated? How many celebrities have I treated? I’m a Malibu physician. I treat outside the box. I innovate, but I also look at what’s out there in the clinical trial world that could help my patient. 

Because ultimately, if you stop the innovations, you stop progress; you stop healthcare. And it doesn’t help the person, the executive at pharma, when he becomes the patient. Who is he going to go to? You’ve killed off everyone that was innovating, and you’ve instilled fear in every doctor. 

You know, I have the head of an academic center today who called me; her kid has COVID. She’s scared of giving ivermectin. She says, am I going to lose my license if I write ivermectin? You’re a gastroenterologist, come on. We have to be better. We have to be braver. The art of medicine needs to remain an art.

Mr. Jekielek:

So when it comes to the art of refloralization, I really like this term. It’s a very nice term for something that maybe doesn’t look as nice if you keep staring at it. But you have had this case. I know that you’re still working on publishing the research where you did this with twins. And we know that the twin studies are very popular for a bunch of reasons because the genetics are identical. What happened? 

Dr. Hazan:

So from COVID and from doing that N of One, which took time, and then from trying to get this familial FMT, I had these kids who were basically coming in with autism. I have a lot of patients that come to me that have tried so many things. And so this case was two twins whose mom flew in from Tennessee. I felt bad for her, and I basically innovated. But I said to her, let me look at the microbiome. 

What was amazing about this case—and it’s going to be a breakthrough—I don’t want to say too much because it’s going to be published in October at the American College of Gastroenterology, but essentially, we saw the identical, out of trillions of microbes, we saw elevation, relative abundance of microbes elevated in the same three phyla in both identical kids. And as we re-floralized the gut, not with fecal transplant but with methods, we basically noticed that those microbes disappeared and the good bacteria came on at the same time as speech started. 

So this was a breakthrough case, and it’s going to be a breakthrough for the FDA once they see that, and we’re going to use that. So we’re going to start doing familial fecal transplants with the FDA, but we’re hoping that we can bring this other method after, you know, while we’re doing familial fecal transplants to get the data to understand, because this could have been a fluke with these two kids, but we want to try to reproduce these two kids to see if we can do this for other kids. 

Therefore, we may run two protocols: one with familial FMT, fecal microbiota transplant, or intestinal microbiota transplant, and then another one with this protocol to kind of see, can we do this more, you know, safer, better, with less playing with poop, you know, because this doesn’t play with poop.

Mr. Jekielek:

And the other aspect is also that, as we said at the beginning, everybody’s different, right? And so just, I think this is actually kind of important. There isn’t a sort of one-size-fits-all solution when it comes to this.

Dr. Hazan:

There isn’t a microbiome. There are trillions of microbes. And like I gave you the example with the fungus, or it could be a fungal overgrowth. Even Dr. Feingold, who at the beginning, basically said, let’s try vancomycin, right? He said, let’s try vancomycin for kids with autism. And he saw something with vancomycin. 

What he was seeing was a destruction of a microbiome and a suppression of microbes that secrete toxins, which decreased the aggressiveness of the kid, but did not restore the speech. But at least it gave a quality of life to the family to say, hey, our kid is not banging his head on the wall. And so vancomycin got us to this level, right? But vancomycin is not a permanent solution. Vancomycin wipes out the gut and puts you in a sterile state and increases some microbes. 

But the solution is really to restore the gut to the way it was. And the challenge that we have is we do not know what it was before. So when you take a kid and he has a destroyed microbiome, you don’t know what the fingerprint of his microbiome was before you reproduce him, right? It’s kind of like destroying a house and you’re trying to reproduce the house, but you don’t know what it looked like. You don’t have the floor plan. You don’t have the architecture before that was done on it. 

So it’s the same thing with a kid. And you’re right, everybody’s different. So everybody may not need the same, but we need to be more precise. What I would like to see in the field of the microbiome and with pharma is to get away from feces and to get into more precise work. In other words, this is a compounding of microbes that this person needs, right? I think that’s what I’d like to see.

Mr. Jekielek:

You know, something just kind of struck me, though. If you’re going to take some sort of therapy, which is going to affect your gut biome, like, for example, you mentioned antibiotics earlier. I don’t know if it was obvious to people. You can basically nuke your gut if you use heavy antibiotics or protracted use of antibiotics. So this creates its own set of problems, like in some cases, C. diff and so forth. Does it make sense to kind of, I don’t know, put some on ice before you if you do have to go into some sort of treatment, and then maybe that might be useful in the future? 

Dr. Hazan:

So I do that with some patients that I see have a spectacular microbiome and are super healthy. I say, you may want to save it. I saved some of mine before COVID because I knew I was going to be on the front line. I was going to be exposed to COVID. And I wanted to make sure I had my original microbiome that I could go back to because I know the genetics in my family. And I know I want to go back to my personality in a way and what I can do. So I kind of wanted that. 

But, yes, that’s the future. Again, there’s red tape with that as well. You need to have a licensed lab. You need to store it properly. You need to make sure it’s the right stools. You don’t want to give someone, you know, who’s diseased a microbiome that was less than perfect. And you got to also say, well, that person who got diseased is what they got was the beginning. Should I give them back the microbes? 

They’re taking antibiotics, but technically, if you take antibiotics, you’re supposed to bounce back. So your microbiome is bouncing back. If you’re not bouncing back, there might be a problem with that microbiome. With the original. Yes, with the original, it’s very rare. 

By the way, and let me just say this to everyone, it’s very difficult to find a perfect microbiome. It is very difficult because everybody’s doing everything. You know, you’re drinking too much; you’re killing your microbiome. Now, if you’re lucky, it bounces back up, and you become resilient and you can tolerate the alcohol. You know, you apply a topical lotion that has some toxins in it that could destroy your microbiome as well. So everything we do affects the microbiome, and you count on your resilience to survive all those things. 

People got vaccinated and got injured, but people got vaccinated and didn’t get injured. What’s the difference between those people? A resilient microbiome is what’s the difference. You know, people that take antibiotics and get into C. diff. What’s the difference with those people? and the person who takes antibiotics and never gets C. diff? Resilience. 

We need to look more carefully at the resilient factor of the microbiome because that’s what allows people to live on more than the presence or the absence of microbes. And like I said, there are trillions of microbes. We’re just touching the surface. I’m telling you right now about C. diff. I’m telling you right now about bifidobacteria. But what about the other bugs? You know, whenever someone tells me, whenever there’s always an arrogant physician that comes up like they know it all, right?

And I always say to them, what’s Dorea? Is that a good bug or a bad bug? What’s Roseburia? Is that a good microbe or a bad microbe? And then they’re like, what? Out of left field. But that’s the reality, right? If you don’t know the microbiome and its trillions of microbes, you have to stay humble in medicine, and you have to stay humble as a human because there are trillions of microbes out there. And if you start killing them group by group, eventually you kill the human. 

The microbiome, to me, is a look at humanity but at the microscopic world, right? You’re looking at all these microbes, groups of microbes coming together to create a healthy human. You kill off the Clostridium, you kill off the bifidobacteria, you kill off the Firmicutes, that human is no longer able to metabolize sugar or to metabolize calcium. Their mitochondria are dead. They’re non-functional. So the microbiome, the balance of the microbiome directs that human because we’re just a reservoir.

When you look, when you go to Venezuela and you have a population that has Giardia in their guts, right? An American goes to Venezuela, gets Giardia, will get diarrhea. A person in Venezuela who is living in that environment with Giardia, they’re fine. They’re resilient. The African microbiome is different from the Amazon jungle, from the Amish population in America. 

So what do all these microbial communities do? There are different regions, and they basically all work the planet. The microbiome underneath the ground of the planet survives thanks to this diversity all around. So you have to look at your, you know, and I always tell my patients about a phylum. 

What is a phylum? It’s a group of microbes that share one thing in common. If you look at the African community, if you look at the Amazon jungle, they have a lot of phyla, a lot of groups of microbes that share one thing in common. Americans barely have three or four. Now we are globalizing the world with our American ways, and we’re making Africa look like America. So are we going to decrease those phyla in Africa and therefore mimic America? And now we’ve lost groups of microbes that were supposed to sustain that, you know, African community. 

I’ll take it one step further. You take a person from the Amazon jungle who lives in the jungle. They’ve adapted to the Amazon. They’ve adapted to the jungle. I will go to the jungle probably because I live in this sterile environment. I’ll get sick because I’ve not seen these microbes in my life. But now you start giving food from America to the Amazon jungle, guess what’s going to happen? 

You’re going to weaken the Amazon jungle, and they’re not going to be able to survive in their own environment. Now, the microbiome of these Amazonians is going to change in the Amazon. The culture, the fruits, the vegetables, the vegetation is now changing because you’ve kind of made it the same as the microbiome of America. 

So my interest in the microbiome is not just, hey, let’s fix autism. Let’s showcase, you know, Parkinson’s signature microbiome. Let’s showcase Alzheimer’s. My interest is really preserving the microbiome of humanity to say, hey, Japan looks like this. China looks like this. Mexico looks like this because that diversity needs to remain.

Mr. Jekielek:

But I also think the headline here, right, the thing that you’re not mentioning is that all those conditions are actually treatable by affecting the microbiome. And that’s been shown. Right. I don’t know if everybody understands that. And not every person and not every time.

Dr. Hazan:

So here’s the thing. When you say that, it gets the academia to go, oh, my God, she’s talking cures, etc. You can’t really say that until you show the data. Right. We have anecdotal data that shows, you know, if you look at the studies from China, they’ve shown improvement of Parkinson’s with fecal microbiota transplant. Johns Hopkins is going to start a study on that. Right. So we’re at the beginning of all this. Eventually, we’ll go back and say, oh, my God, how archaic these humans were. They were practicing, you know, they were operating on a kidney instead of changing the microbiome.

We’re in the Star Trek era right now. I don’t know if you saw that episode of Star Trek where, you know, the doctor gives a pill and he says to a patient, kidney dialysis? How barbaric. Here, take this pill and call me in the morning. That’s going to be the future. We’re not there yet. It took 62 years to get C. diff into the guidelines of fecal transplant. I think that’s what I’d like to see. 

But right now we need to kind of bring humanity to us for them to listen so that we can advance and move forward. So we can’t really say things like, well, there are cures for this and that because we’re shutting off the academia, the academic doctor, who is basically, you know, within the box of I need this, this and this for you to prove to me that I need to pay attention to your experiment, right? Because we all have that gut feeling that says, hey, look at this study, it validates what I said, you know, I improve, I give raw milk or whatever, you know, and my gut is improved. 

But the raw milk could also have, you know, to the mind of a physician at Harvard, for example, he’ll say, but wait a minute, raw milk has a lot of other microbes that could affect that person. Right. Because you’re dealing with a population that is in a way immunosuppressed, lacking microbes, and now you’re giving them a diverse, you know, product that could be, you know, clean, could not be clean, depending on the practices of the farm that you went to. So, you know, there’s a lot of work that needs to be done. That’s all I’m going to say. 

Mr. Jekielek:

You know, another thing, I guess we should say that there’s potential in all these areas. Very real, very real potential. That’s actually, that’s what I meant. This certainly is not something that’s being broadly done or explored, I understand. But the other thing that you mentioned, which I thought was really interesting, was I think you were suggesting that when your gut flora changes significantly, your personality might change significantly. I think you mentioned that. You alluded to that a few times as we’ve been talking. 

Dr. Hazan:

So we showed data of a signature microbiome in anxiety. Remember, people were very anxious during COVID. And whether it was from the media, whether it was from, you know, whatever, the COVID itself or the treatment, people were very anxious with COVID. And what we noticed with COVID was essentially people, because they were anxious, we were able to test our microbiome and we were able to see a signature microbiome of anxiety. We gave a questionnaire which is a GAD score.

Mr. Jekielek:

Can I just jump in for a sec? When you say you saw a signature, there were some commonalities in the microbiome with everybody who was exhibiting anxiety.

Dr. Hazan:

So we gave people a questionnaire. I worked with Dr. Sasha Bystritzky from UCLA and basically we gave a questionnaire which was a GAD questionnaire. It’s an anxiety score. You basically check the box, like are you sleeping, one to five, best or not. And you get a score at the end. And then depending on the score, the score dictates your anxiety level. What we noticed is that there was a huge correlation with a score that determines anxiety on the GAD questionnaire with a certain microbiome picture. We said, maybe this is how people have anxiety. 

One of the key features with anxiety was this loss of bifidobacteria. We then took the study to another level in bipolars. We said, let’s look at bipolar disorders. And again, an absence of certain microbes and an increase in certain microbes gave us the signature, kind of like a formula. AB is elevated, CD is down. So how do we bring back C and D? 

Mr. Jekielek:

Because the hypothesis is that if you fix that, you can help with the problem.

Dr. Hazan:

That’s the hypothesis, right? And that’s exactly where I want to get pharma to say, hey, this is a hypothesis. Let’s test this out and give the opposite formula, right? And so what we did is we started looking at that for, you know, bipolar disorder, anxiety. Why? I had a case with a guy who was suicidal, super anxious, suicidal, psoriasis, C. diff, chronic UTI. 

And basically I gave him a fecal transplant from a stool bank from Dr. Alex Khoruts, who has done some amazing work. I want to acknowledge all these doctors because we wouldn’t be at the microbiome level without the work of all these doctors. And Alex Khoruts basically, you know, had a stool bank, and he gave me a stool from the stool bank for this patient. I had tried giving him his wife’s poop in the beginning as a transplant. It didn’t work. 

And then I gave him this donor from the lab of Alex Khoruts at the University of Minnesota. And basically, the patient’s suicidal ideation disappeared, chronic UTI disappeared, psoriasis disappeared, and C. diff disappeared. And to me, this case—I’ve yet to see the patient; it’s been five years—he’s doing amazing. And we showed engraftment with that case. 

In other words, it latched onto those microbes and persisted in sticking. In fact, I said to him, don’t ever go to Minnesota because there’s someone that’s matching you better than your wife, but that’s like a side joke. But this case essentially showed that the right donor can change the mental status; the right donor can change the suicidal ideation.

Mr. Jekielek:

How was the donor chosen in this case? 

Dr. Hazan:

It was just serendipitous. It was really serendipitous.That’s how research happens, you know, serendipitously. You know, like I said, I picked the wife as a donor to begin with. It turned out he kept having C. diff. And by the way, this was a very interesting case on multiple levels. One, he had diarrhea, but we kept testing him at the lab with the conventional test that we have for C. diff., and we kept finding he was negative, negative, negative. We never could prove he had C. diff. 

And finally, when I did genetic sequencing of the gut and I saw it, I said, I got to keep doing these lab tests from the conventional lab because that’s what proves that he has C. diff. It took me 11 stool samples to prove that he had C. diff. On the 11th one, he finally had C. diff. I treated him for C. diff. conventionally, but it didn’t succeed. He kept having diarrhea. 

We treated him twice. And then we started considering the wife as a donor for C. diff., and that didn’t work. So then that’s when I called Alex and I said, can I have some stools? Well, you can’t do that anymore because it’s all kind of regulated. And Alex is doing his own work with Dr. Adams on autism. So, you know, back then it was much easier to just call a physician that had a stool bank and say, hey, can you get me the best stool donor? 

And why I like that physician is because he’s taking the history—he’s getting from the history. You know, the worst mistake we make is taking stools from a person we think is healthy, but really that person is not healthy. You come to find out the person was an alcoholic, the person is a druggie, the person is bipolar, you know, didn’t tell you. So history taking of donors is very important, and that’s an art on its own.

Mr. Jekielek:

How do you determine, given everything you’ve just said about diversity and so forth, it also sounds like you’ve been on this quest to find the perfect microbiome, or that that actually exists as a concept. So what is that? 

Dr. Hazan:

It’s not defined yet. It’s not something—there are all these lab tests out there, stool tests that tell you, oh, you have these microbes, and people kind of like, you know, put their money on these stool tests. And when you look at these stool tests, actually, it was a study from Scott Jackson that showed that these stool tests are not validated. They’re not reproducible. You know, different labs show different results. And I even tested myself with these labs, right? 

Because I would have never opened ProgenaBiome if there was a lab out there that could give me valid, verified, reproducible data. You want to make sure that when you test your stool sample, you get the same data. If I show one day you have akkermansia in your stool, like a 10 percent elevation of akkermansia, you want to retest the same stool sample in a different lab, and you want to show the same 10 percent acromantia. If one lab is giving you  akkermansia, but another lab shows you elevated bacteroides, that’s not valid. That’s not reproducible, right? 

So when people come to me and they say, well, doctor, I have zero bifidobacteria. How do you know? Well, I tested. Well, how do you know what they tested? At what level of depth of the microbiome did they test? And did they test your food that you ate last night? Or are they testing the baseline of your microbiome? So there are multifactorial reasons why the testing itself needs to be perfect in order to get that reproducibility of that data, what I showed with, you know, the vaccines before and after. You have to have a validated reproducible assay to do that, right? Because otherwise, you can’t really show the data. 

If one day you have akkermansia that’s high, one day you have bifidobacteria, one day you don’t have Bifidobacteria. You have to have some kind of way of knowing, and there are different pipelines that we do when we analyze the stools to see what’s elevated, what’s really elevated, and we retest, right? Because we have to reproduce the data. 

So when you look at that and you look at the stools and you kind of say, what’s going on there? What is the perfect microbiome? You’re not going to understand these microbes unless you try to remove these microbes and see if you change the disease. 

With autism, for example, Dr. Feingold, who wrote the book on anaerobic infections, basically started with the idea that Clostridium perfringens is the bacteria behind autism. Then he said, no, wait, there’s Desulfovibrio as the bacteria. Somebody else comes along and says, no, it’s this other microbe. So is it the Desulfovibrio? Is it Clostridium perfringens? I found Lactobacillus animalis was elevated in my kid with autism, right? I found Bacteroides plebeius. Is it one microbe? So here we are all different. And here we are, every disease has a different microbe that causes that predisposition. Why? That’s where we need to be. 

So how do you understand what is a perfect microbiome? You can’t really. You’re practicing the art of medicine. You’re practicing taking a history from the patient and saying, let me find clues of what you did that got me here. It’s playing detective, right? It’s like finding the murderer at the end, right? You’re trying to find the bug that caused the problem in a trillion. So it’s like a needle in a haystack. 

And then you’re trying to fix, to remove that needle gently without disrupting the haystack, right? So that’s where we are in the microbiome. We can’t really say this is a perfect microbiome. We can guess what a perfect balance should be, could be. But right now you’re kind of following my hunch. 

Mr. Jekielek:

So you’re taking from people who, for all intents and purposes, are really healthy. 

Dr. Hazan:

After taking a history and doing questionnaires that basically say, okay, this person’s not anxious. If a person is anxious, that person is not qualified to be a microbiome donor, okay? If a person is bipolar, they don’t qualify. If they have anything whatsoever, if they’re taking medications, they do not qualify. So figure out who is the person that’s not taking medicine, that doesn’t drink alcohol, that is not bipolar, that is not depressed, that is not anxious. You know, it’s very difficult. Those people are kind of that needle in the haystack. 

But people are desperate. They listen to these interviews. During COVID, those were desperate times. They listened to all these doctors out there, and they were trying all sorts of things to save themselves. So it’s very important to realize when we get into the—it’s one thing to take ivermectin, for example. It’s another thing to do stools and transfer stools because, unfortunately, the majority of people will not find the perfect microbiome. And the majority of people will find a microbiome that probably may not be compatible with them. That’s another problem.

Mr. Jekielek:

So, you know, I think there’s… So even if you have, you know, very closely genetically matched people? 

Dr. Hazan:

Maybe, but here’s the thing. Microbes, you know, does the person that is resilient have microbes that are secreting toxins that could harm the person that is not? When we pick donors, we do a whole slew of blood work and stool tests, especially stool tests. There are three tests that the FDA requires us to do because there were two cases. I mean, obviously, there have been thousands and thousands of fecal transplants done out there, but there have been two cases where people died, you know? And so, unfortunately, you have to put your guards on when that happens. You have to go back and say, wait a minute, I don’t want that on my shift. Look, I compare fecal transplant or intestinal microbiota transplant to blood transfusion. 

And here’s the thing. Before we did blood transfusions, we didn’t even have a CBC or hemoglobin. We didn’t know what we were looking at. People remember the days of George Washington. They would fix a virus by removing the blood of George Washington. I think that’s probably what killed him because they removed so much blood from him during a virus when that was not the way to do it. 

They had no idea back then what a CBC was. They had no idea what a hemoglobin was. They had no idea that a hemoglobin below seven required a transfusion, but a hemoglobin above seven did not need to transfuse. You just need to, you know, give iron and good nutrition to the patient, right? 

It’s the same thing with fecal transplant. We don’t even have a marker. Now, is bifidobacteria a marker? Is bacteroidetes a marker? We don’t know yet. We need to do those studies to say, does bifidobacteria correlate with this disease, this disease, this disease? And now we have a marker. 

Once you have a marker in the microbiome that you can say, okay, let’s look at these microbes. They seem to be out of whack. Let’s try to fix them. Then you can start saying, okay, well, I need these microbes to offset these microbes that are missing. And then from there, you have to kind of look at the stools and say, well, this one would not fit with this one because this one has a bacteria that’s toxic that could kill this one, right? 

So it’s, again, the same principle as blood. You’re not going to give a blood transfusion if you don’t test for hepatitis C or HIV, right? Because we’ve learned that if you give blood to hemophiliacs, when we gave blood to hemophiliacs, they got hepatitis C, but we didn’t know then, right?

So this is why you don’t stop research. You keep looking for answers over and over again. In the microbiome space, we’re very early. We’re 10 miles out of hundreds, you know? This is not in my lifetime. This is going to be, you know, hundreds of years, probably. Of course, with AI, we may be speeding it up, but, you know, AI has its own little problems. So we have to be careful with AI as well.

Mr. Jekielek:

So there seems to be, you know, quite a bit of open-minded thinking around health, especially preventative medicine, but, of course, in the treatment of all sorts. And there’s this huge focus on autism right now. You know, what would be your recommendations in terms of, you know, approaching the autism question through the biome, for example, or more broadly?

Dr. Hazan:

This is something that I’d love to work on with government, and not only this government, but probably with governments from around the world as well. Because autism, like I said, affects everyone. Every country has kids with autism. If we could come together to help these kids, what a great thing that would be. You know, I think it is, I think this is the right time to start that focus. I think what COVID did is it removed our trust, removed our trust in the agencies, removed our trust in the government, removed our trust from pharmaceutical companies. 

I think I’m the right person to kind of bring it all together to say, look, you want me to trust you, then let’s start doing the research properly where we look at the microbiome, where we understand these diseases properly, where we work together. You know, the guidelines that drive research are ICH GCP guidelines.They were created not just for America. They were created around the world. So we all have, as clinical trials doctors, we come together with doctors around the world. 

Part of the reason that I stepped into the pandemic was because I knew I had colleagues in Italy that were doing clinical trials. I had colleagues in Germany that were doing clinical trials. I could call Italy and say, what’s been working for you? And then I could apply it for my patients and my population here in America. I think the same way that research joins all of us, we need to start joining together to understand and to fix these kids. 

Because here’s the big problem. One in 12-and-a-half boys in California have autism. When are we going to start paying attention? When one in one kid is autistic? And if not now, when? We need to start now in order for our kids and our children to survive because our children are our future. And the only way to fix that is to all come together as human beings for the goodness of our children and the generations in the future.

Mr. Jekielek:

Dr. Sabine Hazan, it’s such a pleasure to have you on the show.

Dr. Hazan:

Thank you. And thank you again for having me.

 

This interview was edited for clarity and brevity.