Hello Alopecia World,

I am thinking of getting FMT treatment in the next few months and was wondering if anybody has tried this course of action to treat their alopecia? It doesn't look fun, but there's been quite a bit of research linking a person's gut bacteria with the functioning of their autoimmune system.

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I saw that program and to honest I do not think it is going to help AA. However, that being said I am not a doctor but did see that it helped for those with Colitis and Corhns Disease.I would wait on the procedure till there is further information on AA.

FMT has never been meant as a first line treatment for hair loss.  There's no scientific/scholarly studies on it for that, only some anecdotal blog posts here and there by people without any scientific credentials and who proceeded with FMT on a "hunch."  I'd be extremely wary of anyone who is offering it to you as treatment for hair loss.  See this article and the big questions it raises: http://dl.umsu.ac.ir/bitstream/Hannan/75920/1/4.pdf.  See also this Wired article, which is optimistically written and briefly details a couple of cases of hair growth as an unintended and confusing side effect, but also highlights how very little is known about FMT: https://www.wired.com/2016/11/microbiome-therapy-making-fecal-trans...

Studies of FMT almost exclusively focus on its use for treatment of C.diff infection and irritable bowel disease.  There are no studies definitively linking AA to imbalances in gut microbiota.  

There are also no studies demonstrating hair growth as a consistent outcome of FMT.  How does your provider know that hair growth will result from FMT for YOU?  How does your FMT provider intend to determine which bacteria your gut supposedly needs?  How does he or she intend to properly screen the FM to be transplanted, to ensure that it has the right amount of bacteria that you supposedly need?  How does the provider intend to properly measure the amount of FM that is being transplanted?  What other side effects might you expect to see, good and bad?

These are all questions that your provider should be able to answer in a forthright and detailed way, with backup from scholarly/scientific studies and more than just anecdotal evidence from a select few patients.  If the provider can only tell you about his or her own patients, then the provider should be able to detail to you the protocol by which he or she has followed those patients to link their hair growth to the FMT.  

If your provider gets even slightly offended by these questions, is confused as to why you're asking these questions, or has any difficulty answering them whatsoever, it should raise a major, major red flag as to the provider's commitment to patient health.

good post. the leaky gut syndrome is getting a huge buzz on the Internet lately.
before even considering the FMT, I heard the zonulin test will assess leaky gut syndrome.

Yes, it's definitely getting major buzz.  And like any emerging theory, snake oil salesman attach themselves to it, claim that practically every problem under the sun is caused by whatever it is, rely on anecdotal evidence or a handful of single or very small case studies, and then offer pseudo-scientific treatments that are meant to cure all your problems.  This type of behavior preys on people's vulnerabilities.

The sad, but honest truth is that we just don't have enough info yet about AA or any other type of alopecia to cure hair loss.

Zonulin is a hormone that shows intestinal permeability, and, from what I understand, it's mostly used in assessing celiac disease.  Whether a leaky gut is related to hair loss from AA is still unclear.  Even more unclear is whether FMT helps either a leaky gut or AA hair loss.

Wondering if you did the FMT. When I asked our doctor about it he said he thought it would be better than all the meds and less chance of complications.  I would do if I lived in England and they would do it for alopecia. 

A major university is now researching FMT as a possible treatment/cure for Alopecia.  FMT is currently only FDA approved for C-diff that is unresponsive to antibiotics. While rather unsavory, it is a once and one type treatment without any need for expensive, long term medications. We will see what transpires. Look for more info mid 2019. 

Did anyone try FMT for alopecia?

A major research paper is supposed to be published next week.  Hope for some promising news!!!

Has anything been updated yet?

Gut Dysbiosis In Alopecia Areata Patients Reveals Overabundance of Firmicutes

and Under Representation of Bacteroides

Brigitte N. Sallee MD1, Rolando Perez-Lorenzo PhD1, Eddy HC. Wang PhD1, Alexa R. Abdelaziz1, James C. Chen PhD1, Lindsey A. Bordone MD1, Angela M. Christiano PhD1,2

1 Department of Dermatology, Columbia University.

2 Department of Genetics, Columbia University.

Alopecia Areata (AA) is one of the most prevalent autoimmune disorders in humans leading to patchy or total loss hair with about a 2% lifetime prevalence. AA has a significant impact on patients’ quality of life, and associations with other autoimmune diseases. The development of AA is influenced by genetic, immunological, and environmental factors, though these are not completely defined. The gut microbiome has an immunomodulatory effect capable of eliciting pathologic immune responses beyond the gut. Our recent studies in the C3H/HeJ mouse model of AA showed that oral broad spectrum antibiotics prevented onset of AA, suggesting the gut microbiota is required for AA onset. Thus, to determine the microbiome composition of patients with AA, we collected skin swabs, hair follicle samples, and stool samples from a cohort of 26 AA patients.  Analysis of 16S rRNA sequencing on stool samples revealed significant differential representation of bacterial taxa, between AA patients and healthy subject specifically, members of the firmicutes and bacteroides phyla, similar to our mouse model findings. When AA patients were compared to healthy controls we found under representation the bacteroides phyla and over representation of the firmicutes phyla in AA gut microbiome, similar to changes reported in other autoimmune disorders. Importantly, there was no difference in the skin or hair follicle microbiome in AA patients as compared to healthy controls, underscoring the importance of gut microbiota dysbiosis in AA patients. The presence of gut microbiota dysbiosis in human AA patients provides a rationale for the development of novel therapeutic strategies for AA patients, including Fecal Microbiota Transfer (FMT) and targeted microbial therapy, since restoring the gut microbiota composition to a healthy state has been suggested as an approach to improve the course of autoimmune diseases, such as AA.

FMT trials are still being evaluated by the FDA. Human trials may start in the fall depending upon the FDA's conclusions. 



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